Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $13.80 / $13.80	Facility	26	$13.80	$13.80	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.19 / $33.19 / $33.19	Facility	TC	$33.19	$33.19	$33.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $46.23 / $67.56	Professional		$37.04	$46.23	$67.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $14.49 / $60.52	Professional	26	$11.69	$14.49	$60.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $31.92 / $48.47	Professional	TC	$25.12	$31.92	$48.47
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.22 / $11.22 / $11.22	Facility	26	$11.22	$11.22	$11.22
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.35 / $27.35 / $27.35	Facility	TC	$27.35	$27.35	$27.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $129.61 / $157.19	Professional		$78.03	$129.61	$157.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.29 / $38.69 / $46.92	Professional	26	$23.29	$38.69	$46.92
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.47 / $90.92 / $110.27	Professional	TC	$61.47	$90.92	$110.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.90 / $45.57 / $112.06	Facility	26	$26.90	$45.57	$112.06
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $65.52 / $111.00 / $272.97	Facility	TC	$65.52	$111.00	$272.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.94 / $86.37 / $142.96	Professional		$53.94	$86.37	$142.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.23 / $25.14 / $42.42	Professional	26	$17.23	$25.14	$42.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.11 / $61.23 / $102.49	Professional	TC	$35.11	$61.23	$102.49
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $23.95 / $41.07 / $88.24	Facility	26	$23.95	$41.07	$88.24
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $58.35 / $100.04 / $214.94	Facility	TC	$58.35	$100.04	$214.94
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $68.01 / $80.48 / $137.28	Professional		$68.01	$80.48	$137.28
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $23.43 / $39.96	Professional	26	$19.79	$23.43	$39.96
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $48.21 / $57.07 / $97.33	Professional	TC	$48.21	$57.07	$97.33
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $142.32 / $142.32 / $142.32	Facility	TC	$142.32	$142.32	$142.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $81.94 / $314.00	Professional		$45.46	$81.94	$314.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.96 / $29.22 / $107.32	Professional	26	$15.96	$29.22	$107.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $52.93 / $296.00	Professional	TC	$29.95	$52.93	$296.00
United Facility/Professional Professional Modifier Low / Median / High Price $44.75 / $78.65 / $136.43	Professional		$44.75	$78.65	$136.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.80 / $26.43 / $45.12	Professional	26	$14.80	$26.43	$45.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.95 / $50.53 / $91.31	Professional	TC	$29.95	$50.53	$91.31