Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.96 / $62.96 / $62.96	Facility		$62.96	$62.96	$62.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.15 / $35.15 / $35.15	Facility	26	$35.15	$35.15	$35.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $94.07 / $253.80	Professional		$42.24	$94.07	$253.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $48.81 / $101.56	Professional	26	$34.40	$48.81	$101.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.80 / $39.45 / $163.52	Professional	TC	$27.80	$39.45	$163.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $203.00 / $376.35 / $631.67	Facility		$203.00	$376.35	$631.67
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.23 / $30.23 / $30.23	Facility	26	$30.23	$30.23	$30.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $93.82 / $174.01 / $226.41	Professional		$93.82	$174.01	$226.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.30 / $103.48 / $127.87	Professional	26	$57.30	$103.48	$127.87
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.01 / $81.06 / $98.54	Professional	TC	$45.01	$81.06	$98.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $160.03 / $226.94 / $545.94	Facility		$160.03	$226.94	$545.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.44 / $125.42 / $301.70	Facility	26	$88.44	$125.42	$301.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.85 / $180.17 / $281.20	Professional		$114.85	$180.17	$281.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.08 / $99.67 / $156.11	Professional	26	$64.08	$99.67	$156.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.78 / $80.26 / $128.82	Professional	TC	$50.78	$80.26	$128.82
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $145.41 / $207.10 / $429.88	Facility		$145.41	$207.10	$429.88
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $80.36 / $114.66 / $237.56	Facility	26	$80.36	$114.66	$237.56
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $107.62 / $165.28 / $257.89	Professional		$107.62	$165.28	$257.89
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $60.04 / $92.21 / $143.87	Professional	26	$60.04	$92.21	$143.87
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $47.58 / $73.06 / $114.01	Professional	TC	$47.58	$73.06	$114.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $67.55 / $132.03 / $527.33	Facility		$67.55	$132.03	$527.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $84.18 / $159.71 / $1,317.18	Professional		$84.18	$159.71	$1,317.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.53 / $84.50 / $638.00	Professional	26	$47.53	$84.50	$638.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.22 / $70.12 / $870.88	Professional	TC	$36.22	$70.12	$870.88
United Facility/Professional Facility Modifier Low / Median / High Price $563.00 / $1,749.00 / $2,883.00	Facility		$563.00	$1,749.00	$2,883.00
United Facility/Professional Professional Modifier Low / Median / High Price $80.17 / $144.12 / $259.72	Professional		$80.17	$144.12	$259.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $78.58 / $144.91	Professional	26	$43.67	$78.58	$144.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.43 / $62.82 / $119.41	Professional	TC	$35.43	$62.82	$119.41