Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,199.25 / $1,199.25 / $3,511.00	Facility		$1,199.25	$1,199.25	$3,511.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $599.63 / $599.63 / $599.63	Facility	52	$599.63	$599.63	$599.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,120.69 / $1,199.25 / $1,978.71	Professional		$1,120.69	$1,199.25	$1,978.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,545.96 / $2,801.64 / $3,502.05	Professional		$2,545.96	$2,801.64	$3,502.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,502.90 / $2,092.44 / $3,635.01	Facility		$1,502.90	$2,092.44	$3,635.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,166.35 / $2,924.45 / $9,294.87	Professional		$1,166.35	$2,924.45	$9,294.87
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,509.00 / $2,971.90 / $3,930.43	Facility		$2,509.00	$2,971.90	$3,930.43
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,001.00 / $2,774.36 / $3,431.55	Professional		$2,001.00	$2,774.36	$3,431.55
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,643.56 / $2,162.92 / $2,465.98	Professional		$1,643.56	$2,162.92	$2,465.98
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $484.51 / $484.51 / $484.51	Professional	80	$484.51	$484.51	$484.51
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $484.51 / $484.51 / $484.51	Professional	AS	$484.51	$484.51	$484.51
United Facility/Professional Facility Modifier Low / Median / High Price $3,143.00 / $3,143.00 / $3,143.00	Facility		$3,143.00	$3,143.00	$3,143.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,400.60 / $2,448.38 / $3,557.54	Professional		$1,400.60	$2,448.38	$3,557.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,260.00 / $2,658.90 / $2,765.20	Professional		$2,260.00	$2,658.90	$2,765.20