Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $616.60	Professional		$549.54	$549.54	$616.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $1,513.56 / $1,862.09	Facility		$169.82	$1,513.56	$1,862.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,122.02 / $1,412.54	Professional		$1,122.02	$1,122.02	$1,412.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,818.38 / $4,265.80 / $5,011.87	Facility		$2,818.38	$4,265.80	$5,011.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $2,691.53 / $2,818.38 / $9,332.54	Professional		$2,691.53	$2,818.38	$9,332.54
Midlands Facility/Professional Professional Modifier Low / Median / High Price $3,388.44 / $3,388.44 / $3,388.44	Professional		$3,388.44	$3,388.44	$3,388.44
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 $1,318.26 / $1,318.26 / $1,318.26	Professional		$1,318.26	$1,318.26	$1,318.26
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $275.42 / $2,754.23	Professional		$125.89	$275.42	$2,754.23
Wellmark Facility/Professional Facility Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Facility		$549.54	$549.54	$549.54
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $549.54 / $549.54	Professional		$549.54	$549.54	$549.54