Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.78 / $119.78 / $119.78	Facility		$119.78	$119.78	$119.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.38 / $99.40 / $119.78	Professional		$85.38	$99.40	$119.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $253.94 / $253.94 / $253.94	Facility		$253.94	$253.94	$253.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.27 / $231.74 / $289.68	Professional		$183.27	$231.74	$289.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.26 / $144.29 / $233.94	Facility		$120.26	$144.29	$233.94
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $77.91 / $233.66	Professional		$76.45	$77.91	$233.66
Midlands Facility/Professional Facility Modifier Low / Median / High Price $164.45 / $247.47 / $312.32	Facility		$164.45	$247.47	$312.32
Midlands Facility/Professional Professional Modifier Low / Median / High Price $152.91 / $233.66 / $319.05	Professional		$152.91	$233.66	$319.05
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $181.86 / $303.10 / $350.08	Professional		$181.86	$303.10	$350.08
United Facility/Professional Professional Modifier Low / Median / High Price $53.52 / $77.91 / $127.43	Professional		$53.52	$77.91	$127.43
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $127.43 / $127.43 / $127.43	Professional		$127.43	$127.43	$127.43