Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $123.03	Professional		$112.20	$112.20	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $323.59 / $407.38	Facility		$169.82	$323.59	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $181.97 / $223.87	Professional		$181.97	$181.97	$223.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $218.78 / $831.76	Facility		$128.82	$218.78	$831.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $1,202.26	Professional		$128.82	$128.82	$1,202.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $213.80	Professional		$154.88	$154.88	$213.80
Midlands Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Facility		$169.82	$169.82	$204.17
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $831.76 / $831.76	Professional		$831.76	$831.76	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $263.03 / $812.83	Professional		$125.89	$263.03	$812.83
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Professional		$112.20	$112.20	$112.20