Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.20 / $19.05 / $19.05	Facility	26	$18.20	$19.05	$19.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $131.83 / $426.58	Professional		$57.54	$131.83	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $25.12 / $77.62	Professional	26	$16.98	$25.12	$77.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $28.84 / $28.84	Professional	50	$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $45.71 / $95.50	Professional	TC	$40.74	$45.71	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $162.18	Professional		$114.82	$128.82	$162.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $38.02 / $47.86	Professional	26	$35.48	$38.02	$47.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $91.20 / $114.82	Professional	TC	$79.43	$91.20	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $100.00 / $416.87	Professional		$57.54	$100.00	$416.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $32.36 / $114.82	Professional	26	$19.05	$32.36	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $302.00	Professional	TC	$42.66	$67.61	$302.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $117.49 / $151.36	Professional		$112.20	$117.49	$151.36
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $37.15 / $45.71	Professional	26	$35.48	$37.15	$45.71
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $79.43 / $104.71	Professional	TC	$77.62	$79.43	$104.71
Midlands Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $131.83	Professional		$112.20	$112.20	$131.83
Midlands Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $35.48 / $42.66	Professional	26	$35.48	$35.48	$42.66
Midlands Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $77.62 / $91.20	Professional	TC	$77.62	$77.62	$91.20
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $97.72 / $131.83	Professional		$70.79	$97.72	$131.83
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.90 / $38.90	Professional	26	$20.89	$30.90	$38.90
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $93.33	Professional	TC	$47.86	$67.61	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $100.00 / $138.04	Professional		$64.57	$100.00	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $32.36 / $39.81	Professional	26	$20.89	$32.36	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $69.18 / $100.00	Professional	TC	$44.67	$69.18	$100.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $144.54	Professional		$120.23	$144.54	$144.54
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $43.65 / $43.65	Professional	26	$36.31	$43.65	$43.65
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $102.33 / $102.33	Professional	TC	$83.18	$102.33	$102.33