Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.46 / $12.46 / $12.46	Facility	26	$12.46	$12.46	$12.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.63 / $115.56 / $197.00	Professional		$83.63	$115.56	$197.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.85 / $11.55 / $77.43	Professional	26	$10.85	$11.55	$77.43
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $41.82 / $41.82 / $145.60	Professional	52	$41.82	$41.82	$145.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.26 / $104.06 / $197.58	Professional	TC	$72.26	$104.06	$197.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $139.90 / $174.11 / $215.48	Professional		$139.90	$174.11	$215.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.69 / $23.36 / $28.79	Professional	26	$18.69	$23.36	$28.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $121.21 / $150.84 / $186.69	Professional	TC	$121.21	$150.84	$186.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $162.12 / $768.54	Professional		$98.13	$162.12	$768.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.50 / $24.54 / $267.48	Professional	26	$13.50	$24.54	$267.48
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $84.63 / $153.88 / $698.48	Professional	TC	$84.63	$153.88	$698.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $121.00 / $162.12 / $214.62	Professional		$121.00	$162.12	$214.62
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $97.05 / $139.01 / $158.49	Professional		$97.05	$139.01	$158.49
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $15.01 / $19.86 / $22.82	Professional	26	$15.01	$19.86	$22.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $83.30 / $119.15 / $135.85	Professional	TC	$83.30	$119.15	$135.85
United Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $154.26 / $229.64	Professional		$98.13	$154.26	$229.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.82 / $21.97 / $25.85	Professional	26	$12.82	$21.97	$25.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $84.63 / $132.10 / $198.88	Professional	TC	$84.63	$132.10	$198.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $151.00 / $177.60 / $184.70	Professional		$151.00	$177.60	$184.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $21.60 / $25.40 / $26.40	Professional	26	$21.60	$25.40	$26.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $129.40 / $152.30 / $158.30	Professional	TC	$129.40	$152.30	$158.30