Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,383.76 / $1,383.76 / $1,383.76	Facility		$1,383.76	$1,383.76	$1,383.76
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $691.88 / $691.88 / $691.88	Facility	52	$691.88	$691.88	$691.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,483.92 / $2,338.55 / $4,253.38	Facility		$1,483.92	$2,338.55	$4,253.38
Midlands Facility/Professional Facility Modifier Low / Median / High Price $2,311.98 / $3,473.93 / $4,750.10	Facility		$2,311.98	$3,473.93	$4,750.10
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,812.32 / $2,584.21 / $2,975.74	Professional		$1,812.32	$2,584.21	$2,975.74
Sanford Health Plan Facility/Professional Professional Modifier 80 Low / Median / High Price $574.08 / $574.08 / $574.08	Professional	80	$574.08	$574.08	$574.08
Sanford Health Plan Facility/Professional Professional Modifier AS Low / Median / High Price $574.08 / $574.08 / $574.08	Professional	AS	$574.08	$574.08	$574.08
United Facility/Professional Facility Modifier Low / Median / High Price $4,500.00 / $4,500.00 / $4,500.00	Facility		$4,500.00	$4,500.00	$4,500.00