Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.13 / $57.13 / $57.13	Facility		$57.13	$57.13	$57.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.56 / $57.13 / $57.13	Professional		$48.56	$57.13	$57.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $250.00	Facility		$200.00	$200.00	$250.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.00 / $151.50 / $187.50	Professional		$150.00	$151.50	$187.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.34 / $86.90 / $147.22	Facility		$65.34	$86.90	$147.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $548.62 / $1,576.28 / $1,733.91	Professional		$548.62	$1,576.28	$1,733.91
Midlands Facility/Professional Facility Modifier Low / Median / High Price $176.67 / $202.47 / $227.01	Facility		$176.67	$202.47	$227.01
Midlands Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $181.09 / $202.47	Professional		$61.75	$181.09	$202.47
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $1,338.75 / $1,338.75 / $1,338.75	Professional		$1,338.75	$1,338.75	$1,338.75
United Facility/Professional Professional Modifier Low / Median / High Price $57.13 / $57.13 / $75.41	Professional		$57.13	$57.13	$75.41
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $1,575.00 / $1,575.00 / $1,575.00	Facility		$1,575.00	$1,575.00	$1,575.00
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $1,575.00 / $1,575.00 / $1,575.00	Professional		$1,575.00	$1,575.00	$1,575.00