Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $30.90 / $30.90	Facility	26	$25.12	$30.90	$30.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $131.83 / $363.08	Professional		$64.57	$131.83	$363.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $38.90 / $120.23	Professional	26	$23.99	$38.90	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $100.00 / $275.42	Professional	TC	$69.18	$100.00	$275.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.79 / $70.79 / $70.79	Facility	26	$70.79	$70.79	$70.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $281.84 / $354.81	Professional		$213.80	$281.84	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $89.13	Professional	26	$53.70	$70.79	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $213.80 / $269.15	Professional	TC	$162.18	$213.80	$269.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $870.96	Professional		$85.11	$107.15	$870.96
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $28.84 / $213.80	Professional	26	$21.88	$28.84	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $77.62 / $660.69	Professional	TC	$63.10	$77.62	$660.69
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $229.09	Professional		$223.87	$229.09	$229.09
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $64.57 / $64.57	Professional	26	$57.54	$64.57	$64.57
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $162.18 / $169.82	Professional	TC	$162.18	$162.18	$169.82
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $218.78 / $251.19	Professional		$158.49	$218.78	$251.19
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $56.23 / $63.10	Professional	26	$43.65	$56.23	$63.10
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $162.18 / $186.21	Professional	TC	$114.82	$162.18	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $275.42	Professional		$83.18	$107.15	$275.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.84 / $72.44	Professional	26	$21.38	$28.84	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $77.62 / $204.17	Professional	TC	$63.10	$77.62	$204.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $302.00	Professional		$218.78	$281.84	$302.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $70.79 / $77.62	Professional	26	$56.23	$70.79	$77.62
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $208.93 / $229.09	Professional	TC	$162.18	$208.93	$229.09