Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $195.22 / $195.22 / $2,168.00	Facility		$195.22	$195.22	$2,168.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.63 / $37.63 / $37.63	Facility	26	$37.63	$37.63	$37.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.68 / $215.46 / $1,009.85	Professional		$152.68	$215.46	$1,009.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.63 / $41.97 / $60.85	Professional	26	$37.63	$41.97	$60.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $98.17 / $157.60 / $223.19	Professional	TC	$98.17	$157.60	$223.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.98 / $144.84 / $1,683.38	Facility		$0.98	$144.84	$1,683.38
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $32.25 / $32.25 / $32.25	Facility	26	$32.25	$32.25	$32.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $278.66 / $491.82 / $690.44	Professional		$278.66	$491.82	$690.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.47 / $101.49 / $142.47	Professional	26	$65.47	$101.49	$142.47
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $216.22 / $402.09 / $590.99	Professional	TC	$216.22	$402.09	$590.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $482.62 / $684.41 / $1,646.44	Facility		$482.62	$684.41	$1,646.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $94.33 / $133.78 / $321.82	Facility	26	$94.33	$133.78	$321.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $341.94 / $582.47 / $820.36	Professional		$341.94	$582.47	$820.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.81 / $128.97 / $184.30	Professional	26	$76.81	$128.97	$184.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.12 / $451.61 / $636.05	Professional	TC	$265.12	$451.61	$636.05
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $392.33 / $625.72 / $1,296.41	Facility		$392.33	$625.72	$1,296.41
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $76.69 / $122.30 / $253.40	Facility	26	$76.69	$122.30	$253.40
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $301.05 / $515.17 / $682.72	Professional		$301.05	$515.17	$682.72
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $67.63 / $115.74 / $153.37	Professional	26	$67.63	$115.74	$153.37
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $233.42 / $399.44 / $529.35	Professional	TC	$233.42	$399.44	$529.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $236.09 / $350.06 / $1,727.00	Facility		$236.09	$350.06	$1,727.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $170.70 / $412.00 / $869.39	Professional		$170.70	$412.00	$869.39
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $56.20 / $104.61 / $210.01	Professional	26	$56.20	$104.61	$210.01
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $110.49 / $320.56 / $659.38	Professional	TC	$110.49	$320.56	$659.38
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 $176.39 / $398.71 / $667.71	Professional		$176.39	$398.71	$667.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.18 / $105.06 / $161.29	Professional	26	$52.18	$105.06	$161.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.86 / $329.87 / $480.61	Professional	TC	$117.86	$329.87	$480.61