Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.66 / $25.66 / $25.66	Facility		$25.66	$25.66	$25.66
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.12 / $3.12 / $3.12	Facility	26	$3.12	$3.12	$3.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.58 / $29.01 / $43.49	Professional		$23.58	$29.01	$43.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.87 / $3.91 / $6.78	Professional	26	$2.87	$3.91	$6.78
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.79 / $11.79 / $12.83	Professional	52	$11.79	$11.79	$12.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.70 / $25.10 / $37.97	Professional	TC	$20.70	$25.10	$37.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.52 / $47.46 / $59.32	Professional		$38.52	$47.46	$59.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $4.59 / $5.66 / $6.98	Professional	26	$4.59	$5.66	$6.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.97 / $41.87 / $52.34	Professional	TC	$33.97	$41.87	$52.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.37 / $42.76 / $61.90	Facility		$29.37	$42.76	$61.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $39.46 / $311.26	Professional		$24.89	$39.46	$311.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $3.61 / $5.12 / $129.00	Professional	26	$3.61	$5.12	$129.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.28 / $30.14 / $252.63	Professional	TC	$21.28	$30.14	$252.63
Midlands Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $48.99 / $57.36	Facility		$40.01	$48.99	$57.36
Midlands Facility/Professional Professional Modifier Low / Median / High Price $39.04 / $42.38 / $61.02	Professional		$39.04	$42.38	$61.02
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $24.89 / $37.94 / $44.64	Professional		$24.89	$37.94	$44.64
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $3.86 / $5.17 / $6.38	Professional	26	$3.86	$5.17	$6.38
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $30.07 / $38.81	Professional	TC	$21.02	$30.07	$38.81
United Facility/Professional Professional Modifier Low / Median / High Price $27.40 / $29.13 / $50.49	Professional		$27.40	$29.13	$50.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.75 / $4.05 / $7.79	Professional	26	$3.75	$4.05	$7.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $25.38 / $35.46	Professional	TC	$23.11	$25.38	$35.46
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $50.00 / $52.00	Professional		$42.50	$50.00	$52.00
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $6.50 / $6.80	Professional	26	$5.50	$6.50	$6.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $37.00 / $43.50 / $45.20	Professional	TC	$37.00	$43.50	$45.20