Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $217.33 / $262.83 / $2,525.00	Facility		$217.33	$262.83	$2,525.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $163.00 / $197.12 / $197.12	Facility	54	$163.00	$197.12	$197.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.33 / $277.54 / $512.52	Professional		$217.33	$277.54	$512.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $416.31 / $635.69 / $836.10	Professional	50	$416.31	$635.69	$836.10
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $163.00 / $198.78 / $819.31	Professional	54	$163.00	$198.78	$819.31
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $32.60 / $39.42 / $79.34	Professional	55	$32.60	$39.42	$79.34
BCBS Facility/Professional Facility Modifier Low / Median / High Price $755.43 / $1,629.21 / $3,529.62	Facility		$755.43	$1,629.21	$3,529.62
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $1,325.40 / $2,010.93 / $3,525.98	Facility	50	$1,325.40	$2,010.93	$3,525.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $338.95 / $495.40 / $837.14	Professional		$338.95	$495.40	$837.14
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $495.27 / $716.45 / $1,175.54	Professional	50	$495.27	$716.45	$1,175.54
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $276.50 / $392.94 / $630.59	Professional	54	$276.50	$392.94	$630.59
BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $67.59 / $97.48 / $159.96	Professional	55	$67.59	$97.48	$159.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $609.48 / $864.77 / $2,080.32	Facility		$609.48	$864.77	$2,080.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $365.19 / $614.54 / $1,037.33	Professional		$365.19	$614.54	$1,037.33
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $495.72 / $790.61 / $1,638.05	Facility		$495.72	$790.61	$1,638.05
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $355.16 / $561.73 / $975.01	Professional		$355.16	$561.73	$975.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $262.04 / $440.17 / $1,826.99	Facility		$262.04	$440.17	$1,826.99
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $3,757.05 / $3,757.05 / $3,819.51	Facility	50	$3,757.05	$3,757.05	$3,819.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $294.32 / $479.31 / $2,048.79	Professional		$294.32	$479.31	$2,048.79
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $526.92 / $690.53 / $3,056.40	Professional	50	$526.92	$690.53	$3,056.40
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $298.64 / $298.64 / $298.64	Professional	54	$298.64	$298.64	$298.64
United Facility/Professional Facility Modifier Low / Median / High Price $1,755.00 / $2,872.00 / $4,241.00	Facility		$1,755.00	$2,872.00	$4,241.00
United Facility/Professional Professional Modifier Low / Median / High Price $269.80 / $432.33 / $973.76	Professional		$269.80	$432.33	$973.76