Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.95 / $20.95 / $20.95	Facility	26	$20.95	$20.95	$20.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.90 / $72.51 / $127.89	Professional		$67.90	$72.51	$127.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.10 / $18.60 / $32.54	Professional	26	$18.10	$18.60	$32.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.79 / $53.90 / $95.34	Professional	TC	$49.79	$53.90	$95.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.25 / $107.81 / $107.81	Professional		$86.25	$107.81	$107.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.25 / $29.06 / $29.06	Professional	26	$23.25	$29.06	$29.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.00 / $78.75 / $78.75	Professional	TC	$63.00	$78.75	$78.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.83 / $118.09 / $160.66	Professional		$72.83	$118.09	$160.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.42 / $38.29 / $57.23	Professional	26	$22.42	$38.29	$57.23
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $66.42 / $102.39 / $159.60	Professional	TC	$66.42	$102.39	$159.60
Midlands Facility/Professional Professional Modifier Low / Median / High Price $99.12 / $118.09 / $196.97	Professional		$99.12	$118.09	$196.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $90.10 / $124.83 / $146.85	Professional		$90.10	$124.83	$146.85
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $24.46 / $34.09 / $40.11	Professional	26	$24.46	$34.09	$40.11
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $65.64 / $90.73 / $106.74	Professional	TC	$65.64	$90.73	$106.74
United Facility/Professional Professional Modifier Low / Median / High Price $90.28 / $99.67 / $153.02	Professional		$90.28	$99.67	$153.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $24.84 / $56.86	Professional	26	$17.79	$24.84	$56.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $65.90 / $66.42 / $125.42	Professional	TC	$65.90	$66.42	$125.42
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $139.90 / $164.60 / $164.60	Professional		$139.90	$164.60	$164.60
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $38.20 / $45.00 / $45.00	Professional	26	$38.20	$45.00	$45.00
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $101.70 / $119.60 / $119.60	Professional	TC	$101.70	$119.60	$119.60