Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $789.70 / $789.70 / $6,781.00	Facility		$789.70	$789.70	$6,781.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $592.28 / $592.28 / $592.28	Facility	54	$592.28	$592.28	$592.28
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $118.46 / $118.46 / $118.46	Facility	55	$118.46	$118.46	$118.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $741.17 / $861.73 / $1,597.64	Professional		$741.17	$861.73	$1,597.64
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $592.28 / $658.54 / $1,198.23	Professional	54	$592.28	$658.54	$1,198.23
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $112.65 / $131.71 / $194.68	Professional	55	$112.65	$131.71	$194.68
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,384.23 / $4,797.20 / $8,615.51	Facility		$2,384.23	$4,797.20	$8,615.51
BCBS Facility/Professional Facility Modifier 50 Low / Median / High Price $5,313.75 / $8,062.11 / $14,136.20	Facility	50	$5,313.75	$8,062.11	$14,136.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,161.14 / $1,568.13 / $2,593.71	Professional		$1,161.14	$1,568.13	$2,593.71
BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $928.91 / $1,253.65 / $2,012.73	Professional	54	$928.91	$1,253.65	$2,012.73
BCBS Facility/Professional Professional Modifier 55 Low / Median / High Price $229.91 / $313.41 / $503.70	Professional	55	$229.91	$313.41	$503.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,839.50 / $2,608.65 / $6,275.45	Facility		$1,839.50	$2,608.65	$6,275.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,248.24 / $2,038.45 / $3,501.06	Professional		$1,248.24	$2,038.45	$3,501.06
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $1,671.42 / $2,384.92 / $4,941.30	Facility		$1,671.42	$2,384.92	$4,941.30
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $1,096.46 / $1,739.93 / $2,961.63	Professional		$1,096.46	$1,739.93	$2,961.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $939.17 / $1,425.27 / $5,620.12	Facility		$939.17	$1,425.27	$5,620.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $876.01 / $1,480.65 / $3,621.38	Professional		$876.01	$1,480.65	$3,621.38
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $1,023.77 / $1,044.25 / $1,519.62	Professional	54	$1,023.77	$1,044.25	$1,519.62
Medica Facility/Professional Professional Modifier 55 Low / Median / High Price $337.20 / $337.20 / $337.20	Professional	55	$337.20	$337.20	$337.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,735.00 / $4,974.00 / $8,812.00	Facility		$2,735.00	$4,974.00	$8,812.00
United Facility/Professional Professional Modifier Low / Median / High Price $876.01 / $1,415.44 / $2,953.29	Professional		$876.01	$1,415.44	$2,953.29