Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.27 / $322.87 / $2,168.00	Facility		$251.27	$322.87	$2,168.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $188.45 / $242.15 / $242.15	Facility	54	$188.45	$242.15	$242.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $243.80 / $320.79 / $1,249.38	Professional		$243.80	$320.79	$1,249.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $341.79 / $508.50 / $742.89	Professional	50	$341.79	$508.50	$742.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $188.45 / $242.15 / $481.03	Professional	54	$188.45	$242.15	$481.03
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $37.69 / $48.43 / $96.21	Professional	55	$37.69	$48.43	$96.21
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 $391.13 / $579.96 / $1,018.02	Professional		$391.13	$579.96	$1,018.02
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $583.54 / $846.95 / $1,413.14	Professional	50	$583.54	$846.95	$1,413.14
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $317.36 / $463.97 / $753.67	Professional	54	$317.36	$463.97	$753.67
BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $77.95 / $115.33 / $193.32	Professional	55	$77.95	$115.33	$193.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $749.23 / $1,063.05 / $2,557.30	Facility		$749.23	$1,063.05	$2,557.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $433.00 / $747.25 / $1,264.44	Professional		$433.00	$747.25	$1,264.44
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $609.38 / $971.88 / $2,013.63	Facility		$609.38	$971.88	$2,013.63
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $414.16 / $684.83 / $1,188.67	Professional		$414.16	$684.83	$1,188.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $302.31 / $516.90 / $1,421.20	Facility		$302.31	$516.90	$1,421.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $337.04 / $566.84 / $1,613.01	Professional		$337.04	$566.84	$1,613.01
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $645.05 / $1,269.10 / $3,538.35	Professional	50	$645.05	$1,269.10	$3,538.35
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 $337.04 / $551.52 / $1,118.35	Professional		$337.04	$551.52	$1,118.35