Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,485.15 / $1,485.15 / $1,485.15	Facility		$1,485.15	$1,485.15	$1,485.15
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $742.58 / $742.58 / $742.58	Facility	52	$742.58	$742.58	$742.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,596.54 / $2,509.90 / $4,351.01	Facility		$1,596.54	$2,509.90	$4,351.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,489.63 / $3,740.69 / $5,135.97	Facility		$2,489.63	$3,740.69	$5,135.97
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,872.50 / $2,795.98 / $3,202.16	Professional		$1,872.50	$2,795.98	$3,202.16
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $621.17 / $621.17 / $621.17	Professional	80	$621.17	$621.17	$621.17
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $621.17 / $621.17 / $621.17	Professional	AS	$621.17	$621.17	$621.17
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