Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.97 / $33.97 / $33.97	Facility	26	$33.97	$33.97	$33.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.82 / $57.01 / $83.04	Professional		$51.82	$57.01	$83.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.94 / $32.50 / $50.60	Professional	26	$29.94	$32.50	$50.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.32 / $29.21 / $61.73	Professional	TC	$19.32	$29.21	$61.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.28 / $139.58 / $174.48	Professional		$113.28	$139.58	$174.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.26 / $65.14 / $80.26	Professional	26	$54.26	$65.14	$80.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.17 / $75.37 / $94.22	Professional	TC	$61.17	$75.37	$94.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.34 / $105.65 / $486.90	Professional		$55.34	$105.65	$486.90
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $32.58 / $58.95 / $196.52	Professional	26	$32.58	$58.95	$196.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $37.22 / $244.63	Professional	TC	$21.27	$37.22	$244.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $59.79 / $106.69 / $147.69	Professional		$59.79	$106.69	$147.69
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $68.79 / $92.75 / $128.72	Professional		$68.79	$92.75	$128.72
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.04 / $50.59 / $59.51	Professional	26	$36.04	$50.59	$59.51
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $28.03 / $50.43 / $69.22	Professional	TC	$28.03	$50.43	$69.22
United Facility/Professional Professional Modifier Low / Median / High Price $53.53 / $100.62 / $133.82	Professional		$53.53	$100.62	$133.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.54 / $58.46 / $68.78	Professional	26	$31.54	$58.46	$68.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.27 / $46.83 / $60.14	Professional	TC	$21.27	$46.83	$60.14
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $132.80 / $138.10 / $162.50	Professional		$132.80	$138.10	$162.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $61.40 / $63.80 / $75.09	Professional	26	$61.40	$63.80	$75.09
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $71.40 / $74.30 / $87.40	Professional	TC	$71.40	$74.30	$87.40