Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $2.00 / $2.00 / $2.00	Facility	26	$2.00	$2.00	$2.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $16.98 / $40.74	Professional		$12.88	$16.98	$40.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.02 / $8.91	Professional	26	$2.00	$3.02	$8.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $12.88 / $29.51	Professional	TC	$10.96	$12.88	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $31.62 / $39.81	Professional		$25.12	$31.62	$39.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $3.98 / $5.13 / $6.61	Professional	26	$3.98	$5.13	$6.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $26.30 / $33.11	Professional	TC	$20.89	$26.30	$33.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $162.18	Professional		$21.38	$36.31	$162.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $4.68 / $7.59 / $53.70	Professional	26	$4.68	$7.59	$53.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.18 / $128.82	Professional	TC	$16.98	$28.18	$128.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $40.74 / $51.29	Professional		$35.48	$40.74	$51.29
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $8.51 / $10.96	Professional	26	$6.31	$8.51	$10.96
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $32.36 / $40.74	Professional	TC	$28.84	$32.36	$40.74
Midlands Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $45.71 / $45.71	Professional		$28.18	$45.71	$45.71
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $9.33 / $9.33	Professional	26	$5.75	$9.33	$9.33
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $36.31 / $36.31	Professional	TC	$22.39	$36.31	$36.31
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $28.84 / $37.15	Professional		$17.38	$28.84	$37.15
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $3.09 / $5.13 / $9.33	Professional	26	$3.09	$5.13	$9.33
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $22.91 / $30.20	Professional	TC	$13.80	$22.91	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $33.88 / $53.70	Professional		$20.89	$33.88	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $7.24 / $11.48	Professional	26	$4.27	$7.24	$11.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $26.92 / $41.69	Professional	TC	$16.22	$26.92	$41.69
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $29.51 / $34.67	Professional		$28.18	$29.51	$34.67
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $5.25 / $6.17	Professional	26	$5.01	$5.25	$6.17
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $24.55 / $28.18	Professional	TC	$23.44	$24.55	$28.18