Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.08 / $537.75 / $1,189.90	Facility		$102.08	$537.75	$1,189.90
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $266.49 / $692.47 / $1,016.07	Facility	50	$266.49	$692.47	$1,016.07
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $22.12 / $22.12 / $32.61	Facility	52	$22.12	$22.12	$32.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $63.15 / $185.02	Professional		$40.47	$63.15	$185.02
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.05 / $94.73 / $384.00	Professional	50	$55.05	$94.73	$384.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.62 / $124.66 / $185.04	Professional		$90.62	$124.66	$185.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.36 / $102.72 / $156.82	Facility		$63.36	$102.72	$156.82
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,175.26 / $1,175.26 / $1,175.26	Facility	50	$1,175.26	$1,175.26	$1,175.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $147.80 / $482.48	Professional		$70.20	$147.80	$482.48
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $179.20 / $203.10 / $247.30	Professional	50	$179.20	$203.10	$247.30
Midlands Facility/Professional Facility Modifier Low / Median / High Price $73.95 / $111.28 / $165.96	Facility		$73.95	$111.28	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $91.11 / $119.56 / $162.13	Professional		$91.11	$119.56	$162.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $89.85 / $126.79	Professional		$65.59	$89.85	$126.79
United Facility/Professional Facility Modifier Low / Median / High Price $821.00 / $821.00 / $821.00	Facility		$821.00	$821.00	$821.00
United Facility/Professional Professional Modifier Low / Median / High Price $65.03 / $110.05 / $171.19	Professional		$65.03	$110.05	$171.19
United Facility/Professional Professional Modifier 50 Low / Median / High Price $166.88 / $166.88 / $166.88	Professional	50	$166.88	$166.88	$166.88
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $87.30 / $106.80 / $153.90	Professional		$87.30	$106.80	$153.90