Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.23 / $13.23 / $13.23	Facility	26	$13.23	$13.23	$13.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.15 / $44.12 / $74.64	Professional		$41.15	$44.12	$74.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.24 / $12.36 / $18.69	Professional	26	$11.24	$12.36	$18.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.92 / $30.89 / $55.94	Professional	TC	$29.92	$30.89	$55.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.89 / $92.82 / $116.03	Professional		$64.89	$92.82	$116.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.41 / $24.43 / $30.53	Professional	26	$18.41	$24.43	$30.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.64 / $68.39 / $85.49	Professional	TC	$47.64	$68.39	$85.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.62 / $70.11 / $251.93	Professional		$42.62	$70.11	$251.93
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $22.40 / $76.73	Professional	26	$12.70	$22.40	$76.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.32 / $48.44 / $175.19	Professional	TC	$29.32	$48.44	$175.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $50.10 / $79.87 / $102.16	Professional		$50.10	$79.87	$102.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $47.63 / $64.40 / $86.04	Professional		$47.63	$64.40	$86.04
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $14.28 / $19.80 / $23.29	Professional	26	$14.28	$19.80	$23.29
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $32.60 / $44.83 / $62.75	Professional	TC	$32.60	$44.83	$62.75
United Facility/Professional Professional Modifier Low / Median / High Price $41.17 / $68.62 / $88.54	Professional		$41.17	$68.62	$88.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.70 / $21.59 / $31.75	Professional	26	$12.70	$21.59	$31.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.08 / $46.22 / $64.58	Professional	TC	$27.08	$46.22	$64.58
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $83.80 / $98.60 / $102.60	Professional		$83.80	$98.60	$102.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $22.70 / $26.70 / $27.80	Professional	26	$22.70	$26.70	$27.80
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $61.20 / $71.90 / $74.80	Professional	TC	$61.20	$71.90	$74.80