Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Facility		$137.93	$137.93	$137.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $210.00 / $210.00 / $262.50	Facility		$210.00	$210.00	$262.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.50 / $130.50 / $163.13	Professional		$130.50	$130.50	$163.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $183.53 / $194.55	Facility		$108.60	$183.53	$194.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $108.60 / $1,027.45	Professional		$108.60	$108.60	$1,027.45
Midlands Facility/Professional Facility Modifier Low / Median / High Price $130.32 / $265.29 / $349.07	Facility		$130.32	$265.29	$349.07
Midlands Facility/Professional Professional Modifier Low / Median / High Price $130.32 / $153.69 / $265.29	Professional		$130.32	$153.69	$265.29
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $150.94 / $150.94 / $150.94	Professional		$150.94	$150.94	$150.94
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $151.72	Professional		$137.93	$137.93	$151.72
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $108.60 / $108.60	Facility		$108.60	$108.60	$108.60
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $108.60 / $108.60	Professional		$108.60	$108.60	$108.60