Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $789.70 / $789.70 / $4,362.12	Facility		$789.70	$789.70	$4,362.12
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $592.28 / $592.28 / $592.28	Facility	54	$592.28	$592.28	$592.28
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $118.46 / $118.46 / $118.46	Facility	55	$118.46	$118.46	$118.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $726.79 / $1,081.36 / $3,840.80	Professional		$726.79	$1,081.36	$3,840.80
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $485.82 / $592.28 / $973.41	Professional	54	$485.82	$592.28	$973.41
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $45.02 / $97.16 / $194.68	Professional	55	$45.02	$97.16	$194.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,544.86 / $1,700.00 / $2,125.00	Professional		$1,544.86	$1,700.00	$2,125.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $647.76 / $1,094.71 / $2,119.76	Facility		$647.76	$1,094.71	$2,119.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $698.74 / $1,345.97 / $2,495.60	Professional		$698.74	$1,345.97	$2,495.60
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $1,148.68 / $1,148.68 / $1,148.68	Professional	54	$1,148.68	$1,148.68	$1,148.68
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,392.31 / $1,842.67 / $2,200.39	Facility		$1,392.31	$1,842.67	$2,200.39
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,223.70 / $1,844.72 / $2,200.39	Professional		$1,223.70	$1,844.72	$2,200.39
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $895.33 / $1,253.39 / $1,429.00	Professional		$895.33	$1,253.39	$1,429.00
United Facility/Professional Facility Modifier Low / Median / High Price $2,714.00 / $2,714.00 / $2,714.00	Facility		$2,714.00	$2,714.00	$2,714.00
United Facility/Professional Professional Modifier Low / Median / High Price $919.15 / $1,287.98 / $2,093.73	Professional		$919.15	$1,287.98	$2,093.73
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,392.70 / $1,704.00 / $1,704.00	Professional		$1,392.70	$1,704.00	$1,704.00