Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.09 / $45.09 / $45.09	Facility	26	$45.09	$45.09	$45.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.54 / $75.20 / $106.04	Professional		$65.54	$75.20	$106.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.69 / $42.25 / $114.85	Professional	26	$39.69	$42.25	$114.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.28 / $35.24 / $91.67	Professional	TC	$23.28	$35.24	$91.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.66 / $164.70 / $205.88	Professional		$133.66	$164.70	$205.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.78 / $84.96 / $104.69	Professional	26	$70.78	$84.96	$104.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.70 / $80.95 / $101.20	Professional	TC	$65.70	$80.95	$101.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.70 / $131.86 / $622.15	Professional		$69.70	$131.86	$622.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.77 / $78.03 / $262.07	Professional	26	$42.77	$78.03	$262.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $43.26 / $264.17	Professional	TC	$24.72	$43.26	$264.17
Midlands Facility/Professional Professional Modifier Low / Median / High Price $75.44 / $130.16 / $176.54	Professional		$75.44	$130.16	$176.54
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $82.01 / $110.57 / $152.02	Professional		$82.01	$110.57	$152.02
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $47.54 / $66.54 / $78.27	Professional	26	$47.54	$66.54	$78.27
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.33 / $53.63 / $73.75	Professional	TC	$32.33	$53.63	$73.75
United Facility/Professional Professional Modifier Low / Median / High Price $63.81 / $121.97 / $157.78	Professional		$63.81	$121.97	$157.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.83 / $77.38 / $91.04	Professional	26	$41.83	$77.38	$91.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.38 / $50.36 / $64.68	Professional	TC	$26.38	$50.36	$64.68
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $156.80 / $163.10 / $191.90	Professional		$156.80	$163.10	$191.90
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $80.70 / $84.00 / $98.80	Professional	26	$80.70	$84.00	$98.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $76.09 / $79.09 / $93.10	Professional	TC	$76.09	$79.09	$93.10