Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.73 / $16.73 / $16.73	Facility	26	$16.73	$16.73	$16.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $49.20 / $133.50	Professional		$42.15	$49.20	$133.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.47 / $18.19 / $56.70	Professional	26	$14.47	$18.19	$56.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.68 / $38.51 / $78.30	Professional	TC	$27.68	$38.51	$78.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.06 / $107.82 / $134.78	Professional		$86.06	$107.82	$134.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.45 / $37.22 / $46.54	Professional	26	$30.45	$37.22	$46.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.72 / $70.59 / $88.24	Professional	TC	$48.72	$70.59	$88.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.44 / $77.76 / $301.08	Professional		$44.44	$77.76	$301.08
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.29 / $31.88 / $104.20	Professional	26	$19.29	$31.88	$104.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.15 / $41.92 / $196.89	Professional	TC	$25.15	$41.92	$196.89
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $389.01 / $389.01 / $389.01	Facility	26	$389.01	$389.01	$389.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $77.76 / $88.88 / $117.70	Professional		$77.76	$88.88	$117.70
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $67.04 / $89.92	Professional		$46.84	$67.04	$89.92
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.89 / $27.80 / $31.70	Professional	26	$19.89	$27.80	$31.70
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.83 / $43.41 / $58.22	Professional	TC	$26.83	$43.41	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $50.93 / $68.34 / $84.86	Professional		$50.93	$68.34	$84.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.68 / $25.71 / $32.14	Professional	26	$17.68	$25.71	$32.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.44 / $41.63 / $52.98	Professional	TC	$31.44	$41.63	$52.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.70 / $100.80 / $100.80	Professional		$85.70	$100.80	$100.80
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $35.50 / $35.50	Professional	26	$30.20	$35.50	$35.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $55.50 / $65.30 / $65.30	Professional	TC	$55.50	$65.30	$65.30