Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.85 / $14.85 / $14.85	Facility	26	$14.85	$14.85	$14.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.90 / $54.56 / $90.90	Professional		$47.90	$54.56	$90.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.54 / $14.06 / $32.93	Professional	26	$12.54	$14.06	$32.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $35.36 / $40.50 / $69.03	Professional	TC	$35.36	$40.50	$69.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $126.44 / $158.05	Professional		$103.40	$126.44	$158.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.01 / $31.80 / $39.75	Professional	26	$26.01	$31.80	$39.75
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.39 / $94.64 / $118.29	Professional	TC	$77.39	$94.64	$118.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.42 / $99.31 / $325.58	Professional		$64.42	$99.31	$325.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.92 / $27.62 / $91.83	Professional	26	$17.92	$27.62	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.81 / $71.69 / $233.75	Professional	TC	$45.81	$71.69	$233.75
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $51.73 / $51.73 / $51.73	Facility	26	$51.73	$51.73	$51.73
Midlands Facility/Professional Professional Modifier Low / Median / High Price $106.93 / $121.14 / $130.90	Professional		$106.93	$121.14	$130.90
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $91.67 / $104.80	Professional		$67.27	$91.67	$104.80
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $24.60 / $27.26	Professional	26	$18.44	$24.60	$27.26
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $48.61 / $66.72 / $77.63	Professional	TC	$48.61	$66.72	$77.63
United Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $96.62 / $112.10	Professional		$63.91	$96.62	$112.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.78 / $24.88 / $30.72	Professional	26	$16.78	$24.88	$30.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.50 / $69.75 / $85.45	Professional	TC	$46.50	$69.75	$85.45
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $99.80 / $117.50 / $117.50	Professional		$99.80	$117.50	$117.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $25.90 / $30.50 / $30.50	Professional	26	$25.90	$30.50	$30.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $74.00 / $87.00 / $87.00	Professional	TC	$74.00	$87.00	$87.00