Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $4,626.00 / $13,050.00 / $28,253.95	Facility		$4,626.00	$13,050.00	$28,253.95
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $942.84 / $942.84 / $942.84	Facility	54	$942.84	$942.84	$942.84
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $270.00 / $270.00 / $270.00	Facility	AS	$270.00	$270.00	$270.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,181.31 / $3,393.03 / $31,503.60	Professional		$1,181.31	$3,393.03	$31,503.60
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $85.59 / $145.91 / $688.00	Professional	AS	$85.59	$145.91	$688.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,252.94 / $2,845.27 / $3,556.59	Professional		$2,252.94	$2,845.27	$3,556.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,789.08 / $2,505.28 / $19,116.05	Facility		$1,789.08	$2,505.28	$19,116.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,395.83 / $2,763.83 / $13,550.61	Professional		$1,395.83	$2,763.83	$13,550.61
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,332.54 / $3,401.69 / $22,205.24	Facility		$2,332.54	$3,401.69	$22,205.24
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,043.23 / $2,833.31 / $3,448.05	Professional		$2,043.23	$2,833.31	$3,448.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,681.04 / $2,234.35 / $2,581.44	Professional		$1,681.04	$2,234.35	$2,581.44
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $503.04 / $503.04 / $503.04	Professional	80	$503.04	$503.04	$503.04
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $503.04 / $503.04 / $503.04	Professional	AS	$503.04	$503.04	$503.04
United Facility/Professional Facility Modifier Low / Median / High Price $6,571.00 / $6,571.00 / $6,571.00	Facility		$6,571.00	$6,571.00	$6,571.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,447.72 / $2,378.39 / $3,699.72	Professional		$1,447.72	$2,378.39	$3,699.72
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,498.30 / $3,056.80 / $3,056.80	Professional		$2,498.30	$3,056.80	$3,056.80