Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.98 / $10.98 / $10.98	Facility	26	$10.98	$10.98	$10.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.69 / $73.69 / $222.30	Professional		$39.69	$73.69	$222.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.69 / $44.10	Professional	26	$9.77	$13.69	$44.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.29 / $48.89 / $105.02	Professional	TC	$28.29	$48.89	$105.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.27 / $82.47 / $103.70	Professional		$66.27	$82.47	$103.70
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.43 / $20.42 / $25.30	Professional	26	$16.43	$20.42	$25.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.84 / $62.30 / $78.00	Professional	TC	$49.84	$62.30	$78.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.61 / $105.41 / $632.00	Professional		$57.61	$105.41	$632.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.37 / $21.52 / $223.21	Professional	26	$14.37	$21.52	$223.21
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.57 / $81.99 / $259.02	Professional	TC	$44.57	$81.99	$259.02
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $105.41 / $119.71	Professional		$70.73	$105.41	$119.71
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $47.00 / $71.91 / $99.79	Professional		$47.00	$71.91	$99.79
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $17.02 / $21.83	Professional	26	$12.20	$17.02	$21.83
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $34.95 / $53.83 / $78.33	Professional	TC	$34.95	$53.83	$78.33
United Facility/Professional Professional Modifier Low / Median / High Price $52.10 / $87.39 / $125.14	Professional		$52.10	$87.39	$125.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.99 / $21.12 / $27.57	Professional	26	$12.99	$21.12	$27.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.00 / $77.16 / $101.28	Professional	TC	$41.00	$77.16	$101.28
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $86.80 / $90.30	Professional		$73.80	$86.80	$90.30
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $18.89 / $22.30 / $23.10	Professional	26	$18.89	$22.30	$23.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $54.80 / $64.50 / $67.09	Professional	TC	$54.80	$64.50	$67.09