Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.04 / $104.04 / $104.04	Facility		$104.04	$104.04	$104.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.35 / $104.04 / $104.04	Professional		$86.35	$104.04	$104.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.50 / $94.50 / $118.13	Professional		$94.50	$94.50	$118.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $94.72 / $133.91 / $256.57	Facility		$94.72	$133.91	$256.57
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.93 / $86.70 / $95.37	Professional		$78.93	$86.70	$95.37
Midlands Facility/Professional Facility Modifier Low / Median / High Price $94.72 / $101.57 / $149.83	Facility		$94.72	$101.57	$149.83
Midlands Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $111.31 / $204.11	Professional		$94.72	$111.31	$204.11
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $88.43 / $88.43	Professional		$88.43	$88.43	$88.43
United Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $95.37	Professional		$86.70	$86.70	$95.37
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Facility		$86.70	$86.70	$86.70
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $86.70 / $86.70 / $86.70	Professional		$86.70	$86.70	$86.70