Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $56.23 / $316.23	Professional		$35.48	$56.23	$316.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $9.55 / $33.11	Professional	26	$8.71	$9.55	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $34.67 / $229.09	Professional	TC	$26.92	$34.67	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $93.33 / $117.49	Professional		$74.13	$93.33	$117.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $21.38 / $26.92	Professional	26	$16.98	$21.38	$26.92
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 $38.02 / $61.66 / $223.87	Professional		$38.02	$61.66	$223.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $16.22 / $25.70	Professional	26	$10.72	$16.22	$25.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $46.77 / $89.13	Professional	TC	$30.90	$46.77	$89.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $83.18 / $89.13	Professional		$75.86	$83.18	$89.13
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.95 / $22.91	Professional	26	$19.05	$19.95	$22.91
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $64.57 / $66.07	Professional	TC	$57.54	$64.57	$66.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $81.28 / $81.28	Professional		$81.28	$81.28	$81.28
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $60.26 / $60.26	Professional	TC	$60.26	$60.26	$60.26
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $67.61 / $75.86	Professional		$46.77	$67.61	$75.86
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $15.85 / $18.20	Professional	26	$11.75	$15.85	$18.20
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $51.29 / $58.88	Professional	TC	$34.67	$51.29	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $70.79 / $102.33	Professional		$45.71	$70.79	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.22 / $21.88	Professional	26	$10.00	$16.22	$21.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $53.70 / $85.11	Professional	TC	$33.88	$53.70	$85.11
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $85.11	Professional		$72.44	$85.11	$85.11
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $20.42 / $20.42	Professional	26	$17.38	$20.42	$20.42
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $64.57 / $64.57	Professional	TC	$54.95	$64.57	$64.57