Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $60.26	Facility	26	$38.90	$38.90	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $89.13 / $208.93	Professional		$67.61	$89.13	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $48.98 / $112.20	Professional	26	$34.67	$48.98	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $83.18	Professional	TC	$26.92	$43.65	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $151.36 / $190.55	Professional		$125.89	$151.36	$190.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $93.33	Professional	26	$64.57	$75.86	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $77.62 / $95.50	Professional	TC	$60.26	$77.62	$95.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $112.20 / $562.34	Professional		$66.07	$112.20	$562.34
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $67.61 / $234.42	Professional	26	$45.71	$67.61	$234.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $245.47	Professional	TC	$23.99	$39.81	$245.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $128.82 / $173.78	Professional		$117.49	$128.82	$173.78
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $89.13	Professional	26	$74.13	$85.11	$89.13
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $44.67 / $87.10	Professional	TC	$41.69	$44.67	$87.10
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $114.82 / $114.82	Professional		$69.18	$114.82	$114.82
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $77.62 / $77.62	Professional	26	$47.86	$77.62	$77.62
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $36.31	Professional	TC	$21.88	$36.31	$36.31
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $109.65 / $141.25	Professional		$75.86	$109.65	$141.25
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $60.26 / $75.86	Professional	26	$40.74	$60.26	$75.86
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $50.12 / $69.18	Professional	TC	$30.20	$50.12	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $117.49 / $186.21	Professional		$66.07	$117.49	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $72.44 / $114.82	Professional	26	$45.71	$72.44	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $41.69 / $72.44	Professional	TC	$23.99	$41.69	$72.44
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $147.91 / $173.78	Professional		$141.25	$147.91	$173.78
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $74.13 / $87.10	Professional	26	$70.79	$74.13	$87.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $74.13 / $87.10	Professional	TC	$70.79	$74.13	$87.10