Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.65 / $28.65 / $28.65	Facility	26	$28.65	$28.65	$28.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $65.86 / $76.54	Professional		$50.14	$65.86	$76.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.89 / $38.49 / $73.80	Professional	26	$26.89	$38.49	$73.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $54.11 / $54.11 / $54.11	Professional	52	$54.11	$54.11	$54.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.30 / $36.22 / $64.97	Professional	TC	$19.30	$36.22	$64.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $50.00 / $61.88	Professional		$49.50	$50.00	$61.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.50 / $31.82 / $39.38	Professional	26	$31.50	$31.82	$39.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.00 / $18.18 / $22.50	Professional	TC	$18.00	$18.18	$22.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $99.45 / $334.42	Professional		$55.69	$99.45	$334.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $55.48 / $182.49	Professional	26	$35.99	$55.48	$182.49
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $46.73 / $151.88	Professional	TC	$29.85	$46.73	$151.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $64.05 / $86.55 / $144.12	Professional		$64.05	$86.55	$144.12
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $63.66 / $81.13 / $98.02	Professional		$63.66	$81.13	$98.02
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $36.90 / $49.13 / $54.99	Professional	26	$36.90	$49.13	$54.99
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.40 / $30.40 / $42.69	Professional	TC	$24.40	$30.40	$42.69
United Facility/Professional Professional Modifier Low / Median / High Price $56.72 / $89.10 / $116.95	Professional		$56.72	$89.10	$116.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.54 / $48.34 / $60.42	Professional	26	$33.54	$48.34	$60.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $38.22 / $50.96	Professional	TC	$23.17	$38.22	$50.96
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $81.30 / $95.70 / $95.70	Professional		$81.30	$95.70	$95.70
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $52.40 / $61.60 / $61.60	Professional	26	$52.40	$61.60	$61.60
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $29.00 / $34.10 / $34.10	Professional	TC	$29.00	$34.10	$34.10