Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.91 / $22.91 / $22.91	Facility	26	$22.91	$22.91	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $37.15 / $83.18	Professional		$30.90	$37.15	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $23.99 / $58.88	Professional	26	$19.95	$23.99	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $12.02 / $20.89	Professional	TC	$10.00	$12.02	$20.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $74.13 / $91.20	Professional		$53.70	$74.13	$91.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $45.71 / $57.54	Professional	26	$35.48	$45.71	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $27.54 / $33.88	Professional	TC	$19.50	$27.54	$33.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $51.29 / $208.93	Professional		$32.36	$51.29	$208.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $138.04	Professional	26	$22.91	$36.31	$138.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $15.85 / $70.79	Professional	TC	$11.22	$15.85	$70.79
Midlands Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $83.18	Professional		$66.07	$75.86	$83.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $51.29 / $54.95	Professional	26	$45.71	$51.29	$54.95
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.12 / $28.84	Professional	TC	$19.95	$25.12	$28.84
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $69.18	Professional		$69.18	$69.18	$69.18
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Professional	26	$45.71	$45.71	$45.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $22.91 / $22.91	Professional	TC	$22.91	$22.91	$22.91
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $51.29 / $66.07	Professional		$38.02	$51.29	$66.07
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $35.48 / $41.69	Professional	26	$23.99	$35.48	$41.69
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $18.20 / $24.55	Professional	TC	$13.49	$18.20	$24.55
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $53.70 / $77.62	Professional		$32.36	$53.70	$77.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $36.31 / $48.98	Professional	26	$22.39	$36.31	$48.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $17.38 / $30.20	Professional	TC	$11.22	$17.38	$30.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $67.61 / $79.43	Professional		$64.57	$67.61	$79.43
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $42.66 / $50.12	Professional	26	$40.74	$42.66	$50.12
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $25.12 / $29.51	Professional	TC	$23.99	$25.12	$29.51