Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.28 / $21.28 / $21.28	Facility	26	$21.28	$21.28	$21.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.81 / $58.81 / $77.64	Professional		$58.81	$58.81	$77.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $18.41 / $23.03	Professional	26	$18.41	$18.41	$23.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.40 / $40.40 / $49.94	Professional	TC	$40.40	$40.40	$49.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.97 / $152.81 / $191.02	Professional		$124.97	$152.81	$191.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.70 / $47.32 / $59.15	Professional	26	$38.70	$47.32	$59.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.83 / $105.50 / $131.87	Professional	TC	$83.83	$105.50	$131.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.98 / $117.59 / $420.07	Professional		$70.98	$117.59	$420.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $41.22 / $132.09	Professional	26	$26.74	$41.22	$132.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $48.79 / $76.37 / $288.04	Professional	TC	$48.79	$76.37	$288.04
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $71.51 / $71.51 / $71.51	Facility	26	$71.51	$71.51	$71.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $111.00 / $142.47 / $162.13	Professional		$111.00	$142.47	$162.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $78.38 / $107.10 / $126.79	Professional		$78.38	$107.10	$126.79
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $27.46 / $35.34 / $40.11	Professional	26	$27.46	$35.34	$40.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $50.39 / $71.76 / $86.68	Professional	TC	$50.39	$71.76	$86.68
United Facility/Professional Professional Modifier Low / Median / High Price $76.27 / $117.59 / $144.31	Professional		$76.27	$117.59	$144.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.77 / $40.11 / $45.36	Professional	26	$24.77	$40.11	$45.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.53 / $71.01 / $83.54	Professional	TC	$49.53	$71.01	$83.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.80 / $142.10 / $142.10	Professional		$120.80	$142.10	$142.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $45.00 / $45.00	Professional	26	$38.20	$45.00	$45.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $82.60 / $97.20 / $97.20	Professional	TC	$82.60	$97.20	$97.20