Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.00 / $42.00 / $133.93	Facility		$42.00	$42.00	$133.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.28 / $142.16 / $222.57	Professional		$80.28	$142.16	$222.57
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $91.77 / $151.65 / $176.57	Professional	25	$91.77	$151.65	$176.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.86 / $194.70 / $323.95	Professional		$90.86	$194.70	$323.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $79.63 / $142.16 / $256.64	Facility		$79.63	$142.16	$256.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.83 / $195.52 / $592.72	Professional		$126.83	$195.52	$592.72
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $221.98 / $259.20 / $300.89	Professional	25	$221.98	$259.20	$300.89
Midlands Facility/Professional Facility Modifier Low / Median / High Price $199.58 / $283.99 / $367.16	Facility		$199.58	$283.99	$367.16
Midlands Facility/Professional Professional Modifier Low / Median / High Price $195.76 / $237.80 / $341.16	Professional		$195.76	$237.80	$341.16
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $133.11 / $182.98 / $285.93	Professional		$133.11	$182.98	$285.93
United Facility/Professional Professional Modifier Low / Median / High Price $122.13 / $172.44 / $276.04	Professional		$122.13	$172.44	$276.04
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $170.10 / $208.10 / $333.30	Professional		$170.10	$208.10	$333.30