Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.59 / $196.19 / $537.79	Facility		$67.59	$196.19	$537.79
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $170.51 / $293.57 / $600.51	Facility	25	$170.51	$293.57	$600.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.87 / $86.74 / $236.90	Professional		$53.87	$86.74	$236.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $44.69 / $88.47 / $211.06	Professional	25	$44.69	$88.47	$211.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $135.22 / $206.10	Professional		$73.00	$135.22	$206.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.08 / $97.30 / $141.96	Facility		$50.08	$97.30	$141.96
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $149.93 / $149.93 / $186.38	Facility	62	$149.93	$149.93	$186.38
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $23.99 / $23.99 / $29.82	Facility	AS	$23.99	$23.99	$29.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $83.39 / $143.00 / $413.45	Professional		$83.39	$143.00	$413.45
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $106.56 / $143.00 / $234.31	Professional	25	$106.56	$143.00	$234.31
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.58 / $127.78 / $176.13	Facility		$95.58	$127.78	$176.13
Midlands Facility/Professional Professional Modifier Low / Median / High Price $78.75 / $111.69 / $146.33	Professional		$78.75	$111.69	$146.33
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $87.37 / $118.36 / $169.89	Professional		$87.37	$118.36	$169.89
United Facility/Professional Professional Modifier Low / Median / High Price $72.70 / $129.94 / $144.91	Professional		$72.70	$129.94	$144.91
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $93.20 / $102.60 / $143.19	Professional		$93.20	$102.60	$143.19