Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,905.46 / $4,365.16	Facility		$100.00	$1,905.46	$4,365.16
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,019.95 / $3,019.95 / $3,019.95	Facility	50	$3,019.95	$3,019.95	$3,019.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $281.84	Professional		$100.00	$134.90	$281.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $371.54 / $416.87	Professional	50	$181.97	$371.54	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $302.00 / $389.05	Professional		$177.83	$302.00	$389.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $194.98 / $309.03	Facility		$147.91	$194.98	$309.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $239.88 / $1,000.00	Professional		$125.89	$239.88	$1,000.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $251.19 / $288.40	Professional		$239.88	$251.19	$288.40
Midlands Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $229.09 / $269.15	Professional		$223.87	$229.09	$269.15
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $213.80 / $269.15	Professional		$162.18	$213.80	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $812.83 / $812.83	Facility		$812.83	$812.83	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $208.93 / $338.84	Professional		$123.03	$208.93	$338.84
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $263.03 / $331.13	Professional		$213.80	$263.03	$331.13