Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $8.91	Facility	26	$8.91	$8.91	$8.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $63.10 / $186.21	Professional		$50.12	$63.10	$186.21
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $23.99	Professional	26	$7.94	$8.91	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $52.48 / $114.82	Professional	TC	$44.67	$52.48	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $151.36	Professional		$89.13	$123.03	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.78 / $22.39	Professional	26	$13.18	$17.78	$22.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $104.71 / $128.82	Professional	TC	$74.13	$104.71	$128.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $85.11 / $371.54	Professional		$54.95	$85.11	$371.54
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $14.79 / $54.95	Professional	26	$9.12	$14.79	$54.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $69.18 / $316.23	Professional	TC	$45.71	$69.18	$316.23
Midlands Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $134.90	Professional		$104.71	$123.03	$134.90
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.05 / $21.88	Professional	26	$18.20	$19.05	$21.88
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $102.33 / $114.82	Professional	TC	$85.11	$102.33	$114.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $107.15	Professional		$69.18	$107.15	$107.15
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $16.60 / $16.60	Professional	26	$10.23	$16.60	$16.60
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $91.20 / $91.20	Professional	TC	$57.54	$91.20	$91.20
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $89.13 / $109.65	Professional		$64.57	$89.13	$109.65
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.13 / $16.98	Professional	26	$10.00	$14.13	$16.98
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $75.86 / $91.20	Professional	TC	$54.95	$75.86	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $87.10 / $134.90	Professional		$54.95	$87.10	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.45 / $19.50	Professional	26	$8.71	$14.45	$19.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $72.44 / $114.82	Professional	TC	$45.71	$72.44	$114.82
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $109.65 / $128.82	Professional		$104.71	$109.65	$128.82
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.98 / $19.95	Professional	26	$16.22	$16.98	$19.95
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $93.33 / $109.65	Professional	TC	$89.13	$93.33	$109.65