Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.48 / $9.48 / $9.48	Facility	26	$9.48	$9.48	$9.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.75 / $57.86 / $200.70	Professional		$52.75	$57.86	$200.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.77 / $27.75	Professional	26	$7.45	$8.77	$27.75
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.21 / $28.93 / $31.77	Professional	52	$26.21	$28.93	$31.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.29 / $49.16 / $138.15	Professional	TC	$45.29	$49.16	$138.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.38 / $118.64 / $148.30	Professional		$86.38	$118.64	$148.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.15 / $17.45 / $21.81	Professional	26	$13.15	$17.45	$21.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.67 / $101.20 / $126.49	Professional	TC	$73.67	$101.20	$126.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.83 / $94.19 / $373.69	Professional		$54.83	$94.19	$373.69
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.26 / $16.35 / $55.28	Professional	26	$9.26	$16.35	$55.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $45.72 / $78.12 / $318.41	Professional	TC	$45.72	$78.12	$318.41
Midlands Facility/Professional Professional Modifier Low / Median / High Price $68.44 / $105.42 / $134.41	Professional		$68.44	$105.42	$134.41
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $66.06 / $89.35 / $108.68	Professional		$66.06	$89.35	$108.68
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.32 / $14.30 / $16.82	Professional	26	$10.32	$14.30	$16.82
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $54.92 / $74.27 / $91.86	Professional	TC	$54.92	$74.27	$91.86
United Facility/Professional Professional Modifier Low / Median / High Price $54.83 / $101.62 / $155.57	Professional		$54.83	$101.62	$155.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.49 / $19.23	Professional	26	$8.91	$15.49	$19.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.60 / $77.72 / $100.31	Professional	TC	$45.60	$77.72	$100.31
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $105.90 / $124.60 / $129.60	Professional		$105.90	$124.60	$129.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $16.39 / $19.30 / $20.10	Professional	26	$16.39	$19.30	$20.10
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $89.50 / $105.30 / $109.50	Professional	TC	$89.50	$105.30	$109.50