Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $984.75 / $5,523.36 / $9,080.76	Facility		$984.75	$5,523.36	$9,080.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $115.45 / $115.45 / $115.45	Facility	53	$115.45	$115.45	$115.45
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $432.95 / $432.95 / $432.95	Facility	54	$432.95	$432.95	$432.95
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $86.59 / $86.59 / $86.59	Facility	55	$86.59	$86.59	$86.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $525.95 / $1,012.20 / $3,821.36	Professional		$525.95	$1,012.20	$3,821.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,979.23 / $1,979.23 / $1,979.23	Professional	50	$1,979.23	$1,979.23	$1,979.23
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $236.68 / $288.63 / $473.83	Professional	52	$236.68	$288.63	$473.83
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $355.01 / $432.95 / $710.74	Professional	54	$355.01	$432.95	$710.74
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $42.00 / $86.59 / $142.15	Professional	55	$42.00	$86.59	$142.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,129.97 / $1,243.44 / $1,554.30	Professional		$1,129.97	$1,243.44	$1,554.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $473.35 / $799.96 / $1,911.20	Facility		$473.35	$799.96	$1,911.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $542.11 / $1,041.33 / $5,120.10	Professional		$542.11	$1,041.33	$5,120.10
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $823.25 / $839.97 / $1,497.60	Professional	54	$823.25	$839.97	$1,497.60
Medica Facility/Professional Professional Modifier 55 Low / Median / High Price $2.16 / $2.16 / $320.01	Professional	55	$2.16	$2.16	$320.01
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,016.73 / $1,410.03 / $1,821.47	Facility		$1,016.73	$1,410.03	$1,821.47
Midlands Facility/Professional Professional Modifier Low / Median / High Price $983.58 / $1,410.03 / $1,605.53	Professional		$983.58	$1,410.03	$1,605.53
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $654.72 / $981.71 / $1,090.76	Professional		$654.72	$981.71	$1,090.76
United Facility/Professional Facility Modifier Low / Median / High Price $2,714.00 / $2,714.00 / $4,561.46	Facility		$2,714.00	$2,714.00	$4,561.46
United Facility/Professional Professional Modifier Low / Median / High Price $698.44 / $1,128.25 / $1,527.40	Professional		$698.44	$1,128.25	$1,527.40
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,016.90 / $1,244.20 / $1,244.20	Professional		$1,016.90	$1,244.20	$1,244.20