Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $334.01 / $567.80 / $1,656.00	Facility		$334.01	$567.80	$1,656.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $733.78 / $733.78 / $879.69	Facility	50	$733.78	$733.78	$879.69
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $250.51 / $270.08 / $682.48	Facility	54	$250.51	$270.08	$682.48
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $50.10 / $54.02 / $54.02	Facility	55	$50.10	$54.02	$54.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $350.29 / $693.20	Professional		$269.14	$350.29	$693.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $1,022.84 / $2,346.00	Professional	50	$436.08	$1,022.84	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $250.51 / $277.13 / $497.92	Professional	54	$250.51	$277.13	$497.92
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $50.10 / $55.43 / $107.11	Professional	55	$50.10	$55.43	$107.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $755.43 / $1,603.60 / $2,752.60	Facility		$755.43	$1,603.60	$2,752.60
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 $489.28 / $697.50 / $1,170.75	Professional		$489.28	$697.50	$1,170.75
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $729.93 / $1,005.87 / $1,647.08	Professional	50	$729.93	$1,005.87	$1,647.08
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $401.16 / $560.96 / $889.77	Professional	54	$401.16	$560.96	$889.77
BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $97.86 / $138.00 / $222.81	Professional	55	$97.86	$138.00	$222.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $839.30 / $1,190.84 / $2,864.75	Facility		$839.30	$1,190.84	$2,864.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $526.87 / $874.48 / $1,443.98	Professional		$526.87	$874.48	$1,443.98
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $682.65 / $1,088.72 / $2,255.71	Facility		$682.65	$1,088.72	$2,255.71
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $521.65 / $787.83 / $1,336.07	Professional		$521.65	$787.83	$1,336.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $328.25 / $590.71 / $1,814.96	Facility		$328.25	$590.71	$1,814.96
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $911.59 / $911.59 / $1,338.89	Facility	50	$911.59	$911.59	$1,338.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $390.13 / $665.25 / $1,536.36	Professional		$390.13	$665.25	$1,536.36
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $705.23 / $902.95 / $2,194.56	Professional	50	$705.23	$902.95	$2,194.56
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $433.99 / $468.37 / $700.72	Professional	54	$433.99	$468.37	$700.72
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 $365.40 / $597.91 / $1,271.58	Professional		$365.40	$597.91	$1,271.58