Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $8,021.04 / $12,583.49 / $20,304.04	Facility		$8,021.04	$12,583.49	$20,304.04
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $8,570.16 / $8,570.16 / $8,570.16	Facility	50	$8,570.16	$8,570.16	$8,570.16
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $941.96 / $941.96 / $941.96	Facility	54	$941.96	$941.96	$941.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,199.52 / $3,581.36 / $30,367.53	Professional		$1,199.52	$3,581.36	$30,367.53
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $84.59 / $162.58 / $687.35	Professional	AS	$84.59	$162.58	$687.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,405.21 / $2,841.38 / $3,551.72	Professional		$2,405.21	$2,841.38	$3,551.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,656.70 / $2,403.30 / $17,464.55	Facility		$1,656.70	$2,403.30	$17,464.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,453.68 / $2,828.54 / $11,316.67	Professional		$1,453.68	$2,828.54	$11,316.67
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,329.65 / $3,397.19 / $21,750.66	Facility		$2,329.65	$3,397.19	$21,750.66
Midlands Facility/Professional Professional Modifier Low / Median / High Price $2,042.50 / $2,829.67 / $3,444.44	Professional		$2,042.50	$2,829.67	$3,444.44
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,680.61 / $2,233.21 / $2,724.50	Professional		$1,680.61	$2,233.21	$2,724.50
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $502.78 / $502.78 / $502.78	Professional	80	$502.78	$502.78	$502.78
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $502.78 / $502.78 / $502.78	Professional	AS	$502.78	$502.78	$502.78
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 $1,201.28 / $2,375.96 / $3,695.94	Professional		$1,201.28	$2,375.96	$3,695.94
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $2,495.10 / $3,052.90 / $3,052.90	Professional		$2,495.10	$3,052.90	$3,052.90