Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.65 / $162.65 / $162.65	Facility		$162.65	$162.65	$162.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.93 / $162.65 / $162.65	Professional		$115.93	$162.65	$162.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.06 / $314.64 / $393.31	Professional		$201.06	$314.64	$393.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $163.31 / $195.92 / $821.89	Facility		$163.31	$195.92	$821.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $88.25 / $155.72 / $259.55	Professional		$88.25	$155.72	$259.55
Midlands Facility/Professional Facility Modifier Low / Median / High Price $207.64 / $302.80 / $340.53	Facility		$207.64	$302.80	$340.53
Midlands Facility/Professional Professional Modifier Low / Median / High Price $207.64 / $302.80 / $379.21	Professional		$207.64	$302.80	$379.21
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $416.88 / $475.35	Professional		$173.03	$416.88	$475.35
United Facility/Professional Professional Modifier Low / Median / High Price $72.67 / $155.72 / $173.03	Professional		$72.67	$155.72	$173.03
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $173.03 / $173.03 / $173.03	Professional		$173.03	$173.03	$173.03