Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $64.57 / $100.00	Professional		$52.48	$64.57	$100.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $22.91 / $38.90	Professional	26	$18.20	$22.91	$38.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $41.69 / $63.10	Professional	TC	$32.36	$41.69	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $120.23 / $177.83	Professional		$87.10	$120.23	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $66.07	Professional	26	$31.62	$44.67	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $114.82	Professional	TC	$54.95	$75.86	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $69.18 / $436.52	Professional		$44.67	$69.18	$436.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $26.92 / $158.49	Professional	26	$16.60	$26.92	$158.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $42.66 / $281.84	Professional	TC	$28.18	$42.66	$281.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $128.82	Professional		$114.82	$128.82	$128.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $50.12 / $50.12	Professional	26	$42.66	$50.12	$50.12
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $79.43 / $79.43	Professional	TC	$72.44	$79.43	$79.43
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $120.23 / $134.90	Professional		$95.50	$120.23	$134.90
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $44.67 / $47.86	Professional	26	$33.88	$44.67	$47.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $85.11	Professional	TC	$60.26	$77.62	$85.11
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $64.57 / $158.49	Professional		$40.74	$64.57	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $22.91 / $57.54	Professional	26	$14.45	$22.91	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $40.74 / $102.33	Professional	TC	$25.70	$40.74	$102.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $144.54 / $154.88	Professional		$112.20	$144.54	$154.88
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $57.54	Professional	26	$41.69	$53.70	$57.54
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $91.20 / $97.72	Professional	TC	$70.79	$91.20	$97.72