Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.47 / $24.47 / $24.47	Facility	26	$24.47	$24.47	$24.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $78.34 / $114.65	Professional		$35.18	$78.34	$114.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.47 / $27.42 / $66.75	Professional	26	$24.47	$27.42	$66.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.05 / $53.40 / $80.15	Professional	TC	$14.05	$53.40	$80.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $95.41 / $119.26	Professional		$78.03	$95.41	$119.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $55.85 / $69.81	Professional	26	$45.68	$55.85	$69.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.35 / $39.56 / $49.45	Professional	TC	$32.35	$39.56	$49.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.11 / $88.21 / $142.59	Professional		$41.11	$88.21	$142.59
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $44.55 / $66.33	Professional	26	$27.06	$44.55	$66.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.32 / $53.15 / $125.92	Professional	TC	$28.32	$53.15	$125.92
Midlands Facility/Professional Professional Modifier Low / Median / High Price $87.47 / $118.39 / $159.16	Professional		$87.47	$118.39	$159.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $59.32 / $79.56 / $134.03	Professional		$59.32	$79.56	$134.03
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $30.81 / $40.85 / $46.58	Professional	26	$30.81	$40.85	$46.58
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.60 / $32.99 / $88.19	Professional	TC	$24.60	$32.99	$88.19
United Facility/Professional Professional Modifier Low / Median / High Price $47.14 / $88.21 / $133.47	Professional		$47.14	$88.21	$133.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.06 / $28.90 / $47.22	Professional	26	$27.06	$28.90	$47.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.78 / $42.48 / $88.58	Professional	TC	$18.78	$42.48	$88.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $75.80 / $89.20 / $89.20	Professional		$75.80	$89.20	$89.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $44.40 / $52.20 / $52.20	Professional	26	$44.40	$52.20	$52.20
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $31.40 / $37.00 / $37.00	Professional	TC	$31.40	$37.00	$37.00