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 $36.24 / $38.79 / $65.01	Professional		$36.24	$38.79	$65.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.69 / $14.19 / $21.79	Professional	26	$13.69	$14.19	$21.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.10 / $25.50 / $43.20	Professional	TC	$25.10	$25.50	$43.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.45 / $81.65 / $102.07	Professional		$59.45	$81.65	$102.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.57 / $28.61 / $35.77	Professional	26	$21.57	$28.61	$35.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.61 / $53.04 / $66.30	Professional	TC	$38.61	$53.04	$66.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.10 / $70.04 / $348.00	Professional		$38.10	$70.04	$348.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.86 / $26.65 / $89.60	Professional	26	$14.86	$26.65	$89.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.87 / $43.39 / $198.00	Professional	TC	$23.87	$43.39	$198.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $75.63 / $97.01	Professional		$44.11	$75.63	$97.01
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $43.53 / $63.49 / $75.69	Professional		$43.53	$63.49	$75.69
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $23.10 / $27.17	Professional	26	$16.67	$23.10	$27.17
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $26.49 / $39.47 / $48.52	Professional	TC	$26.49	$39.47	$48.52
United Facility/Professional Professional Modifier Low / Median / High Price $38.19 / $65.97 / $83.50	Professional		$38.19	$65.97	$83.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.41 / $26.65 / $31.35	Professional	26	$14.41	$26.65	$31.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.17 / $39.74 / $62.25	Professional	TC	$21.17	$39.74	$62.25
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 $26.50 / $31.20 / $32.40	Professional	26	$26.50	$31.20	$32.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $47.30 / $55.60 / $57.90	Professional	TC	$47.30	$55.60	$57.90