Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.80 / $162.87 / $164.70	Professional		$29.80	$162.87	$164.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $47.70 / $95.40	Professional	26	$10.47	$47.70	$95.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.26 / $89.00 / $231.40	Professional	TC	$21.26	$89.00	$231.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.78 / $74.52 / $112.48	Professional		$55.78	$74.52	$112.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.95 / $19.21 / $70.00	Professional	26	$13.95	$19.21	$70.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $52.30 / $84.36	Professional	TC	$18.20	$52.30	$84.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.15 / $68.70 / $115.74	Facility		$48.15	$68.70	$115.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $74.16 / $360.92	Professional		$24.85	$74.16	$360.92
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.01 / $22.55 / $140.40	Professional	26	$7.01	$22.55	$140.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $52.58 / $268.14	Professional	TC	$17.84	$52.58	$268.14
Midlands Facility/Professional Facility Modifier Low / Median / High Price $49.27 / $92.53 / $166.05	Facility		$49.27	$92.53	$166.05
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $56.10 / $56.10 / $56.10	Facility	26	$56.10	$56.10	$56.10
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $109.95 / $109.95 / $109.95	Facility	TC	$109.95	$109.95	$109.95
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.06 / $74.52 / $100.00	Professional		$69.06	$74.52	$100.00
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.92 / $74.27 / $91.33	Professional		$54.92	$74.27	$91.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.26 / $18.72 / $21.35	Professional	26	$13.26	$18.72	$21.35
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $40.76 / $55.12 / $73.39	Professional	TC	$40.76	$55.12	$73.39
United Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $25.76 / $82.40	Professional		$24.85	$25.76	$82.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.59 / $7.01 / $23.98	Professional	26	$6.59	$7.01	$23.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.84 / $19.17 / $58.42	Professional	TC	$17.84	$19.17	$58.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $72.59 / $93.40 / $100.50	Professional		$72.59	$93.40	$100.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.70 / $24.10 / $25.90	Professional	26	$18.70	$24.10	$25.90
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $53.90 / $69.40 / $74.59	Professional	TC	$53.90	$69.40	$74.59