Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,094.04 / $1,094.04 / $1,094.04	Facility		$1,094.04	$1,094.04	$1,094.04
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $547.02 / $547.02 / $547.02	Facility	52	$547.02	$547.02	$547.02
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $218.81 / $218.81 / $218.81	Facility	53	$218.81	$218.81	$218.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,186.79 / $1,818.96 / $3,192.95	Facility		$1,186.79	$1,818.96	$3,192.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,826.37 / $2,745.02 / $3,791.74	Facility		$1,826.37	$2,745.02	$3,791.74
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,377.53 / $2,053.33 / $2,380.59	Professional		$1,377.53	$2,053.33	$2,380.59
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $456.59 / $456.59 / $456.59	Professional	80	$456.59	$456.59	$456.59
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $456.59 / $456.59 / $456.59	Professional	AS	$456.59	$456.59	$456.59
United Facility/Professional Facility Modifier Low / Median / High Price $2,000.00 / $2,000.00 / $2,000.00	Facility		$2,000.00	$2,000.00	$2,000.00