Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.50 / $22.50 / $67.38	Professional		$22.50	$22.50	$67.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.13 / $67.64 / $81.00	Professional	26	$5.13	$67.64	$81.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.37 / $69.42 / $147.74	Professional	TC	$17.37	$69.42	$147.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.58 / $58.23 / $87.88	Professional		$43.58	$58.23	$87.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.65 / $54.60	Professional	26	$8.27	$11.65	$54.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.00 / $44.12 / $71.18	Professional	TC	$14.00	$44.12	$71.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.20 / $52.88 / $80.87	Facility		$34.20	$52.88	$80.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $59.03 / $263.07	Professional		$18.55	$59.03	$263.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $4.19 / $13.47 / $145.30	Professional	26	$4.19	$13.47	$145.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $14.37 / $46.94 / $226.21	Professional	TC	$14.37	$46.94	$226.21
Midlands Facility/Professional Facility Modifier Low / Median / High Price $38.31 / $70.53 / $149.74	Facility		$38.31	$70.53	$149.74
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $49.31 / $49.31 / $49.31	Facility	26	$49.31	$49.31	$49.31
Midlands Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $58.23 / $78.00	Professional		$52.30	$58.23	$78.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $56.74 / $82.85	Professional		$38.61	$56.74	$82.85
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $11.35 / $12.94	Professional	26	$8.23	$11.35	$12.94
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.04 / $45.39 / $72.56	Professional	TC	$30.04	$45.39	$72.56
United Facility/Professional Professional Modifier Low / Median / High Price $18.55 / $19.97 / $55.42	Professional		$18.55	$19.97	$55.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.00 / $4.19 / $14.64	Professional	26	$4.00	$4.19	$14.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.37 / $15.97 / $46.94	Professional	TC	$14.37	$15.97	$46.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $56.70 / $73.00 / $78.50	Professional		$56.70	$73.00	$78.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $11.30 / $14.60 / $15.70	Professional	26	$11.30	$14.60	$15.70
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $45.40 / $58.40 / $62.80	Professional	TC	$45.40	$58.40	$62.80