Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $67.61 / $107.15	Professional		$57.54	$67.61	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $147.91	Professional	26	$40.74	$48.98	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $19.95 / $29.51	Professional	TC	$17.38	$19.95	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $194.98	Professional		$141.25	$154.88	$194.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $109.65 / $134.90	Professional	26	$100.00	$109.65	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $45.71 / $57.54	Professional	TC	$41.69	$45.71	$57.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $83.18 / $147.91	Professional		$63.10	$83.18	$147.91
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $58.88 / $95.50	Professional	26	$39.81	$58.88	$95.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $25.12 / $39.81	Professional	TC	$16.22	$25.12	$39.81
Midlands Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Professional	26	$107.15	$107.15	$107.15
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $41.69	Professional	TC	$41.69	$41.69	$41.69
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $107.15 / $128.82	Professional		$79.43	$107.15	$128.82
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $75.86 / $89.13	Professional	26	$54.95	$75.86	$89.13
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $31.62 / $37.15	Professional	TC	$23.44	$31.62	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $144.54	Professional		$70.79	$100.00	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $72.44 / $102.33	Professional	26	$50.12	$72.44	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $27.54 / $43.65	Professional	TC	$20.89	$27.54	$43.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $141.25 / $141.25	Professional		$120.23	$141.25	$141.25
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $100.00 / $100.00	Professional	26	$85.11	$100.00	$100.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $41.69 / $41.69	Professional	TC	$35.48	$41.69	$41.69