Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $141.25 / $426.58	Facility		$74.13	$141.25	$426.58
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $229.09 / $229.09 / $371.54	Facility	CO	$229.09	$229.09	$371.54
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $97.72 / $354.81 / $870.96	Facility	CQ	$97.72	$354.81	$870.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.95 / $43.65 / $93.33	Professional		$19.95	$43.65	$93.33
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $25.12 / $56.23 / $125.89	Professional	CQ	$25.12	$56.23	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $31.62 / $32.36	Professional		$25.12	$31.62	$32.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $83.18 / $141.25	Facility		$24.55	$83.18	$141.25
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $56.23 / $56.23 / $114.82	Facility	CO	$56.23	$56.23	$114.82
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $56.23 / $56.23 / $114.82	Facility	CQ	$56.23	$56.23	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $41.69 / $64.57	Professional		$27.54	$41.69	$64.57
Midlands Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $44.67 / $51.29	Professional		$37.15	$44.67	$51.29
Midlands Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $74.13	Professional		$34.67	$34.67	$74.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $44.67 / $57.54	Professional		$33.11	$44.67	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $28.18 / $67.61	Professional		$26.30	$28.18	$67.61
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $40.74 / $47.86	Professional		$37.15	$40.74	$47.86