Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,500.00 / $1,500.00 / $1,500.00	Facility		$1,500.00	$1,500.00	$1,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,500.00 / $1,500.00	Professional		$1,275.00	$1,500.00	$1,500.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,275.00 / $1,275.00 / $1,652.10	Professional		$1,275.00	$1,275.00	$1,652.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $1,350.00 / $2,028.00 / $2,535.00	Facility		$1,350.00	$2,028.00	$2,535.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $5,250.00	Professional		$1,250.00	$1,250.00	$5,250.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,272.97 / $1,652.10 / $2,614.51	Facility		$1,272.97	$1,652.10	$2,614.51
Midlands Facility/Professional Professional Modifier Low / Median / High Price $1,200.99 / $1,272.97 / $1,652.10	Professional		$1,200.99	$1,272.97	$1,652.10
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,020.00 / $1,020.00 / $1,020.00	Professional		$1,020.00	$1,020.00	$1,020.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,250.00 / $1,250.00 / $1,375.00	Professional		$1,250.00	$1,250.00	$1,375.00
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Facility		$1,000.00	$1,000.00	$1,000.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,000.00 / $1,000.00 / $1,000.00	Professional		$1,000.00	$1,000.00	$1,000.00