Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.85 / $15.85 / $15.85	Facility	26	$15.85	$15.85	$15.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $52.48 / $177.83	Professional		$42.66	$52.48	$177.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $21.88 / $56.23	Professional	26	$15.14	$21.88	$56.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $33.11 / $77.62	Professional	TC	$26.92	$33.11	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $109.65 / $138.04	Professional		$89.13	$109.65	$138.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.02 / $47.86	Professional	26	$30.20	$38.02	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $91.20	Professional	TC	$57.54	$72.44	$91.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $56.23 / $93.33	Professional		$40.74	$56.23	$93.33
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $26.92 / $44.67	Professional	26	$16.22	$26.92	$44.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $34.67 / $58.88	Professional	TC	$24.55	$34.67	$58.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $100.00	Professional		$85.11	$91.20	$100.00
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $34.67 / $37.15	Professional	26	$33.11	$34.67	$37.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $58.88 / $64.57	Professional	TC	$48.98	$58.88	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $93.33 / $93.33	Professional		$93.33	$93.33	$93.33
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $35.48	Professional	26	$35.48	$35.48	$35.48
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $58.88	Professional	TC	$58.88	$58.88	$58.88
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $63.10 / $89.13	Professional		$46.77	$63.10	$89.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $26.92 / $31.62	Professional	26	$19.95	$26.92	$31.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $58.88	Professional	TC	$27.54	$38.02	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $67.61 / $93.33	Professional		$44.67	$67.61	$93.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $26.92 / $34.67	Professional	26	$17.38	$26.92	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $57.54	Professional	TC	$25.12	$41.69	$57.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $100.00	Professional		$85.11	$100.00	$100.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $35.48 / $35.48	Professional	26	$30.20	$35.48	$35.48
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $64.57	Professional	TC	$54.95	$64.57	$64.57