Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.48 / $15.48 / $15.48	Facility	26	$15.48	$15.48	$15.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.55 / $44.83 / $70.34	Professional		$42.55	$44.83	$70.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $14.19 / $19.37	Professional	26	$13.69	$14.19	$19.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.86 / $30.65 / $41.80	Professional	TC	$28.86	$30.65	$41.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.20 / $87.79 / $108.17	Professional		$74.20	$87.79	$108.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.59 / $28.32 / $34.90	Professional	26	$23.59	$28.32	$34.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.06 / $59.47 / $73.28	Professional	TC	$51.06	$59.47	$73.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.06 / $99.57 / $541.00	Professional		$50.06	$99.57	$541.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.93 / $27.52 / $91.83	Professional	26	$15.93	$27.52	$91.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $38.19 / $66.48 / $217.68	Professional	TC	$38.19	$66.48	$217.68
Midlands Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $100.54 / $127.06	Professional		$62.78	$100.54	$127.06
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $53.02 / $70.36 / $87.61	Professional		$53.02	$70.36	$87.61
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.64 / $23.25 / $26.62	Professional	26	$16.64	$23.25	$26.62
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $47.09 / $62.08	Professional	TC	$36.31	$47.09	$62.08
United Facility/Professional Professional Modifier Low / Median / High Price $50.06 / $92.00 / $113.65	Professional		$50.06	$92.00	$113.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.75 / $27.29 / $33.15	Professional	26	$14.75	$27.29	$33.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.46 / $64.92 / $80.20	Professional	TC	$32.46	$64.92	$80.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $82.70 / $86.00 / $101.20	Professional		$82.70	$86.00	$101.20
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $27.40 / $28.50 / $33.50	Professional	26	$27.40	$28.50	$33.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $55.40 / $57.60 / $67.80	Professional	TC	$55.40	$57.60	$67.80