Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.04 / $12.04 / $12.04	Facility	26	$12.04	$12.04	$12.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.19 / $91.19 / $102.85	Professional		$91.19	$91.19	$102.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.53 / $10.53 / $12.35	Professional	26	$10.53	$10.53	$12.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $80.22 / $80.66 / $90.81	Professional	TC	$80.22	$80.66	$90.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $163.47 / $236.59 / $295.74	Professional		$163.47	$236.59	$295.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $26.37 / $32.97	Professional	26	$21.57	$26.37	$32.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.53 / $210.21 / $262.77	Professional	TC	$137.53	$210.21	$262.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.88 / $214.14 / $876.62	Professional		$137.88	$214.14	$876.62
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.81 / $22.94 / $270.04	Professional	26	$14.81	$22.94	$270.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $123.78 / $191.20 / $820.61	Professional	TC	$123.78	$191.20	$820.61
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $481.79 / $481.79 / $481.79	Facility	26	$481.79	$481.79	$481.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $163.47 / $187.31 / $243.15	Professional		$163.47	$187.31	$243.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $136.87 / $184.38 / $199.68	Professional		$136.87	$184.38	$199.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $19.86 / $22.64	Professional	26	$15.01	$19.86	$22.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $121.85 / $162.87 / $177.49	Professional	TC	$121.85	$162.87	$177.49
United Facility/Professional Professional Modifier Low / Median / High Price $123.83 / $214.14 / $242.53	Professional		$123.83	$214.14	$242.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.98 / $22.94 / $26.55	Professional	26	$13.98	$22.94	$26.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.85 / $186.03 / $206.65	Professional	TC	$109.85	$186.03	$206.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $184.90 / $217.50 / $217.50	Professional		$184.90	$217.50	$217.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.60 / $25.40 / $25.40	Professional	26	$21.60	$25.40	$25.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $163.30 / $192.10 / $192.10	Professional	TC	$163.30	$192.10	$192.10