Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $15.86 / $15.86	Facility	26	$15.86	$15.86	$15.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $28.85 / $51.69	Professional		$26.23	$28.85	$51.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.75 / $13.97 / $20.30	Professional	26	$13.75	$13.97	$20.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.47 / $13.71 / $35.83	Professional	TC	$12.47	$13.71	$35.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.33 / $92.82 / $116.03	Professional		$75.33	$92.82	$116.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $29.39 / $36.64	Professional	26	$24.03	$29.39	$36.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.54 / $63.51 / $79.39	Professional	TC	$51.54	$63.51	$79.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.24 / $57.12 / $306.10	Professional		$30.24	$57.12	$306.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $28.17 / $93.99	Professional	26	$15.22	$28.17	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $13.52 / $25.16 / $212.11	Professional	TC	$13.52	$25.16	$212.11
Midlands Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $59.86 / $102.31	Professional		$32.11	$59.86	$102.31
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.99 / $61.89 / $86.04	Professional		$43.99	$61.89	$86.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $17.04 / $23.65 / $27.82	Professional	26	$17.04	$23.65	$27.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $19.73 / $42.17 / $58.22	Professional	TC	$19.73	$42.17	$58.22
United Facility/Professional Professional Modifier Low / Median / High Price $29.92 / $65.16 / $89.88	Professional		$29.92	$65.16	$89.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.09 / $27.94 / $39.63	Professional	26	$15.09	$27.94	$39.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.38 / $37.76 / $52.58	Professional	TC	$14.38	$37.76	$52.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $88.70 / $92.30 / $108.60	Professional		$88.70	$92.30	$108.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $28.70 / $29.80 / $35.10	Professional	26	$28.70	$29.80	$35.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $60.10 / $62.50 / $73.50	Professional	TC	$60.10	$62.50	$73.50