Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.46 / $39.46 / $39.46	Facility	26	$39.46	$39.46	$39.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.95 / $72.87 / $99.39	Professional		$66.95	$72.87	$99.39
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.71 / $44.39 / $83.74	Professional	26	$35.71	$44.39	$83.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.57 / $24.82 / $41.52	Professional	TC	$22.57	$24.82	$41.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.08 / $147.94 / $184.94	Professional		$120.08	$147.94	$184.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.93 / $74.34 / $91.60	Professional	26	$61.93	$74.34	$91.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.60 / $74.68 / $93.34	Professional	TC	$60.60	$74.68	$93.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.77 / $118.85 / $568.04	Professional		$67.77	$118.85	$568.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $46.00 / $78.20 / $234.92	Professional	26	$46.00	$78.20	$234.92
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.86 / $41.75 / $244.63	Professional	TC	$23.86	$41.75	$244.63
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.59 / $121.51 / $175.39	Professional		$78.59	$121.51	$175.39
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $106.76 / $137.13	Professional		$78.95	$106.76	$137.13
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $42.06 / $58.29 / $74.84	Professional	26	$42.06	$58.29	$74.84
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $29.99 / $49.97 / $68.56	Professional	TC	$29.99	$49.97	$68.56
United Facility/Professional Professional Modifier Low / Median / High Price $57.37 / $113.22 / $143.13	Professional		$57.37	$113.22	$143.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.83 / $67.70 / $96.60	Professional	26	$32.83	$67.70	$96.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.54 / $46.84 / $60.17	Professional	TC	$24.54	$46.84	$60.17
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.50 / $147.10 / $173.10	Professional		$141.50	$147.10	$173.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.70 / $73.59 / $86.50	Professional	26	$70.70	$73.59	$86.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.70 / $73.59 / $86.50	Professional	TC	$70.70	$73.59	$86.50