Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.83 / $29.83 / $29.83	Facility	26	$29.83	$29.83	$29.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.67 / $63.95 / $264.33	Professional		$59.67	$63.95	$264.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.64 / $28.86 / $65.86	Professional	26	$26.64	$28.86	$65.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $33.03 / $36.33 / $62.65	Professional	TC	$33.03	$36.33	$62.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.42 / $132.60 / $165.75	Professional		$99.42	$132.60	$165.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.08 / $55.83 / $69.79	Professional	26	$42.08	$55.83	$69.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.01 / $76.77 / $95.96	Professional	TC	$56.01	$76.77	$95.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $106.37 / $717.26	Professional		$60.14	$106.37	$717.26
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $51.37 / $330.63	Professional	26	$28.78	$51.37	$330.63
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.36 / $55.00 / $563.89	Professional	TC	$31.36	$55.00	$563.89
Midlands Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $117.05 / $153.53	Professional		$70.75	$117.05	$153.53
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $72.08 / $97.47 / $122.91	Professional		$72.08	$97.47	$122.91
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $32.14 / $44.54 / $52.40	Professional	26	$32.14	$44.54	$52.40
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $37.33 / $51.32 / $70.51	Professional	TC	$37.33	$51.32	$70.51
United Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $100.93 / $126.29	Professional		$56.72	$100.93	$126.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.78 / $51.37 / $60.44	Professional	26	$28.78	$51.37	$60.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.49 / $53.31 / $71.90	Professional	TC	$29.49	$53.31	$71.90
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $119.80 / $140.90 / $146.60	Professional		$119.80	$140.90	$146.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $51.10 / $60.10 / $62.50	Professional	26	$51.10	$60.10	$62.50
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $68.70 / $80.80 / $84.10	Professional	TC	$68.70	$80.80	$84.10