Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.70 / $724.70 / $4,338.00	Facility		$724.70	$724.70	$4,338.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $144.94 / $144.94 / $144.94	Facility	53	$144.94	$144.94	$144.94
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $543.53 / $543.53 / $543.53	Facility	54	$543.53	$543.53	$543.53
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $108.71 / $108.71 / $108.71	Facility	55	$108.71	$108.71	$108.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $602.13 / $609.66 / $1,189.51	Professional		$602.13	$609.66	$1,189.51
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $89.19 / $108.71 / $178.43	Professional	55	$89.19	$108.71	$178.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,420.25 / $1,562.87 / $1,953.59	Professional		$1,420.25	$1,562.87	$1,953.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $513.95 / $854.14 / $4,180.07	Facility		$513.95	$854.14	$4,180.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $642.44 / $1,255.07 / $1,984.95	Professional		$642.44	$1,255.07	$1,984.95
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,113.18 / $1,617.46 / $5,639.55	Facility		$1,113.18	$1,617.46	$5,639.55
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,330.38 / $1,617.46 / $2,059.59	Professional		$1,330.38	$1,617.46	$2,059.59
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $787.96 / $1,151.82 / $1,313.21	Professional		$787.96	$1,151.82	$1,313.21
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 $785.85 / $1,255.07 / $1,952.33	Professional		$785.85	$1,255.07	$1,952.33
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,279.80 / $1,565.90 / $1,565.90	Professional		$1,279.80	$1,565.90	$1,565.90