Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.98 / $36.88 / $48.83	Professional		$28.98	$36.88	$48.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.21 / $16.85 / $35.83	Professional	26	$15.21	$16.85	$35.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.96 / $17.96 / $23.81	Professional	TC	$12.96	$17.96	$23.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.17 / $63.34 / $85.93	Professional		$29.17	$63.34	$85.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.55 / $29.53 / $39.93	Professional	26	$13.55	$29.53	$39.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.62 / $33.42 / $46.00	Professional	TC	$15.62	$33.42	$46.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.78 / $48.64 / $74.45	Facility		$28.78	$48.64	$74.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.15 / $42.29 / $354.38	Professional		$29.15	$42.29	$354.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.11 / $20.46 / $98.32	Professional	26	$14.11	$20.46	$98.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $15.07 / $21.83 / $180.44	Professional	TC	$15.07	$21.83	$180.44
Midlands Facility/Professional Facility Modifier Low / Median / High Price $64.92 / $76.53 / $90.00	Facility		$64.92	$76.53	$90.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $69.88 / $89.26	Professional		$39.86	$69.88	$89.26
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $39.25 / $51.48 / $65.13	Professional		$39.25	$51.48	$65.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $22.67 / $30.40	Professional	26	$18.62	$22.67	$30.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $20.62 / $28.70 / $38.84	Professional	TC	$20.62	$28.70	$38.84
United Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $40.82 / $50.70	Professional		$28.92	$40.82	$50.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.62 / $18.78 / $25.36	Professional	26	$13.62	$18.78	$25.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.04 / $21.83 / $26.70	Professional	TC	$15.04	$21.83	$26.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $45.10 / $61.60 / $64.09	Professional		$45.10	$61.60	$64.09
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.20 / $29.00 / $30.10	Professional	26	$21.20	$29.00	$30.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $23.90 / $32.70 / $34.00	Professional	TC	$23.90	$32.70	$34.00