Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.85 / $12.85 / $12.85	Facility	26	$12.85	$12.85	$12.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $45.27 / $75.79	Professional		$41.15	$45.27	$75.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $11.79 / $18.12	Professional	26	$11.24	$11.79	$18.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.92 / $32.90 / $57.68	Professional	TC	$29.92	$32.90	$57.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.59 / $94.22 / $117.77	Professional		$68.59	$94.22	$117.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.88 / $23.73 / $29.66	Professional	26	$17.88	$23.73	$29.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.91 / $70.48 / $88.11	Professional	TC	$50.91	$70.48	$88.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.27 / $73.34 / $277.95	Professional		$43.27	$73.34	$277.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.19 / $22.14 / $74.58	Professional	26	$13.19	$22.14	$74.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.17 / $51.55 / $203.39	Professional	TC	$30.17	$51.55	$203.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $51.97 / $83.36 / $105.97	Professional		$51.97	$83.36	$105.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $51.06 / $69.04 / $87.33	Professional		$51.06	$69.04	$87.33
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $13.89 / $19.25 / $22.64	Professional	26	$13.89	$19.25	$22.64
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $36.04 / $48.74 / $64.69	Professional	TC	$36.04	$48.74	$64.69
United Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $78.42 / $92.25	Professional		$37.72	$78.42	$92.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.34 / $22.14 / $26.04	Professional	26	$12.34	$22.14	$26.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.93 / $56.28 / $74.31	Professional	TC	$29.93	$56.28	$74.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $85.10 / $100.10 / $104.10	Professional		$85.10	$100.10	$104.10
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.10 / $26.00 / $27.00	Professional	26	$22.10	$26.00	$27.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $63.00 / $74.20 / $77.09	Professional	TC	$63.00	$74.20	$77.09