Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.22 / $29.22 / $29.22	Facility	26	$29.22	$29.22	$29.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $58.31 / $130.83	Professional		$50.14	$58.31	$130.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.89 / $43.55 / $76.54	Professional	26	$26.89	$43.55	$76.54
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.27 / $36.90 / $60.30	Professional	52	$34.27	$36.90	$60.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.58 / $36.86 / $65.86	Professional	TC	$23.58	$36.86	$65.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.60 / $121.78 / $152.22	Professional		$99.60	$121.78	$152.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.29 / $65.16 / $81.45	Professional	26	$53.29	$65.16	$81.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.31 / $56.63 / $70.78	Professional	TC	$46.31	$56.63	$70.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $102.21 / $334.42	Professional		$66.30	$102.21	$334.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.82 / $55.48 / $84.81	Professional	26	$36.82	$55.48	$84.81
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $46.73 / $151.88	Professional	TC	$29.85	$46.73	$151.88
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $102.21 / $102.21 / $102.21	Facility	26	$102.21	$102.21	$102.21
Midlands Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $124.25 / $144.12	Professional		$108.27	$124.25	$144.12
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $89.69 / $101.56	Professional		$67.36	$89.69	$101.56
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.47 / $48.62 / $54.99	Professional	26	$36.47	$48.62	$54.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.58 / $40.85 / $46.58	Professional	TC	$30.58	$40.85	$46.58
United Facility/Professional Professional Modifier Low / Median / High Price $62.32 / $99.45 / $111.38	Professional		$62.32	$99.45	$111.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $53.98 / $63.44	Professional	26	$33.56	$53.98	$63.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.65 / $36.74 / $50.96	Professional	TC	$28.65	$36.74	$50.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $96.80 / $113.80 / $113.80	Professional		$96.80	$113.80	$113.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $61.60 / $61.60	Professional	26	$52.40	$61.60	$61.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $44.40 / $52.20 / $52.20	Professional	TC	$44.40	$52.20	$52.20