Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.94 / $9.94 / $9.94	Facility	26	$9.94	$9.94	$9.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.40 / $28.51 / $53.65	Professional		$28.40	$28.51	$53.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.28 / $9.81 / $26.70	Professional	26	$8.28	$9.81	$26.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $22.14 / $64.08	Professional	TC	$19.57	$22.14	$64.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $74.47 / $93.08	Professional		$60.90	$74.47	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.13 / $20.94 / $26.18	Professional	26	$17.13	$20.94	$26.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.68 / $53.52 / $66.90	Professional	TC	$41.68	$53.52	$66.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.50 / $58.30 / $197.88	Professional		$33.50	$58.30	$197.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.29 / $18.94 / $232.03	Professional	26	$12.29	$18.94	$232.03
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.41 / $34.02 / $142.29	Professional	TC	$20.41	$34.02	$142.29
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $34.72 / $34.72 / $34.72	Facility	26	$34.72	$34.72	$34.72
Midlands Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $71.22 / $78.06	Professional		$53.87	$71.22	$78.06
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $46.60 / $62.10	Professional		$34.02	$46.60	$62.10
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $15.89 / $18.38	Professional	26	$12.59	$15.89	$18.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $32.79 / $43.99	Professional	TC	$21.02	$32.79	$43.99
United Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $55.84 / $59.92	Professional		$37.94	$55.84	$59.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.18 / $18.94 / $22.91	Professional	26	$11.18	$18.94	$22.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $34.02 / $40.98	Professional	TC	$23.86	$34.02	$40.98
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $59.20 / $69.59 / $69.59	Professional		$59.20	$69.59	$69.59
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $17.30 / $20.30 / $20.30	Professional	26	$17.30	$20.30	$20.30
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.90 / $49.30 / $49.30	Professional	TC	$41.90	$49.30	$49.30