Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $904.55 / $904.55 / $4,338.00	Facility		$904.55	$904.55	$4,338.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $678.41 / $678.41 / $678.41	Facility	54	$678.41	$678.41	$678.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $742.46 / $904.55 / $1,489.55	Professional		$742.46	$904.55	$1,489.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $111.37 / $135.68 / $223.43	Professional	55	$111.37	$135.68	$223.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,771.42 / $1,949.31 / $2,436.64	Professional		$1,771.42	$1,949.31	$2,436.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $641.27 / $1,061.72 / $2,034.34	Facility		$641.27	$1,061.72	$2,034.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $801.59 / $1,569.62 / $2,482.62	Professional		$801.59	$1,569.62	$2,482.62
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,393.96 / $2,026.91 / $5,644.32	Facility		$1,393.96	$2,026.91	$5,644.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,664.48 / $2,026.91 / $2,581.01	Professional		$1,664.48	$2,026.91	$2,581.01
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $983.98 / $1,438.36 / $1,639.89	Professional		$983.98	$1,438.36	$1,639.89
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
United Facility/Professional Professional Modifier Low / Median / High Price $984.80 / $1,736.10 / $2,441.63	Professional		$984.80	$1,736.10	$2,441.63
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,598.20 / $1,955.40 / $1,955.40	Professional		$1,598.20	$1,955.40	$1,955.40