Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $124.50 / $150.00 / $150.00	Professional		$124.50	$150.00	$150.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $193.05 / $369.90	Facility		$150.00	$193.05	$369.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $137.50	Professional		$125.00	$125.00	$137.50
Midlands Facility/Professional Facility Modifier Low / Median / High Price $197.70 / $197.70 / $230.65	Facility		$197.70	$197.70	$230.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $150.13 / $150.13	Professional		$150.13	$150.13	$150.13
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $127.50 / $127.50 / $127.50	Professional		$127.50	$127.50	$127.50
United Facility/Professional Professional Modifier Low / Median / High Price $106.25 / $125.00 / $137.50	Professional		$106.25	$125.00	$137.50
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $125.00 / $125.00	Facility		$125.00	$125.00	$125.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $125.00 / $125.00	Professional		$125.00	$125.00	$125.00