Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.23 / $22.23 / $22.23	Facility	26	$22.23	$22.23	$22.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $43.56 / $65.62	Professional		$39.60	$43.56	$65.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.36 / $21.35 / $34.14	Professional	26	$20.36	$21.35	$34.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.23 / $20.05 / $41.14	Professional	TC	$18.23	$20.05	$41.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.59 / $116.55 / $145.69	Professional		$94.59	$116.55	$145.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $41.77 / $51.47	Professional	26	$34.79	$41.77	$51.47
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 $42.64 / $78.52 / $378.70	Professional		$42.64	$78.52	$378.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $38.58 / $130.11	Professional	26	$21.46	$38.58	$130.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $33.45 / $242.47	Professional	TC	$19.12	$33.45	$242.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $84.64 / $124.65	Professional		$44.21	$84.64	$124.65
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $54.06 / $73.34 / $107.39	Professional		$54.06	$73.34	$107.39
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.77 / $32.99 / $38.81	Professional	26	$23.77	$32.99	$38.81
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $46.54 / $68.56	Professional	TC	$23.00	$46.54	$68.56
United Facility/Professional Professional Modifier Low / Median / High Price $42.64 / $81.08 / $105.50	Professional		$42.64	$81.08	$105.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.57 / $38.25 / $45.07	Professional	26	$20.57	$38.25	$45.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.02 / $50.21 / $72.65	Professional	TC	$21.02	$50.21	$72.65
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $115.20 / $135.50	Professional		$110.80	$115.20	$135.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $40.00 / $41.60 / $49.00	Professional	26	$40.00	$41.60	$49.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.70 / $73.59 / $86.50	Professional	TC	$70.70	$73.59	$86.50