Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $664.68 / $664.68 / $3,556.48	Facility		$664.68	$664.68	$3,556.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $614.42 / $669.25 / $965.78	Professional		$614.42	$669.25	$965.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,285.85 / $1,363.43 / $1,704.28	Professional		$1,285.85	$1,363.43	$1,704.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $766.15 / $1,038.39 / $1,768.14	Facility		$766.15	$1,038.39	$1,768.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $702.39 / $1,289.25 / $4,667.04	Professional		$702.39	$1,289.25	$4,667.04
Midlands Facility/Professional Facility Modifier Low / Median / High Price $953.00 / $1,547.77 / $2,383.04	Facility		$953.00	$1,547.77	$2,383.04
Midlands Facility/Professional Professional Modifier Low / Median / High Price $954.00 / $1,412.66 / $1,762.22	Professional		$954.00	$1,412.66	$1,762.22
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $832.50 / $1,101.32 / $1,255.63	Professional		$832.50	$1,101.32	$1,255.63
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $247.72 / $247.72 / $247.72	Professional	80	$247.72	$247.72	$247.72
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $247.72 / $247.72 / $247.72	Professional	AS	$247.72	$247.72	$247.72
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 $766.25 / $1,383.30 / $1,770.55	Professional		$766.25	$1,383.30	$1,770.55
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,295.09 / $1,523.70 / $1,584.60	Professional		$1,295.09	$1,523.70	$1,584.60