Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.15 / $41.15 / $69.54	Facility	26	$41.15	$41.15	$69.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.89 / $178.59 / $679.40	Professional		$105.89	$178.59	$679.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.03 / $52.35 / $154.00	Professional	26	$37.03	$52.35	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.22 / $142.12 / $220.00	Professional	TC	$66.22	$142.12	$220.00
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $33.68 / $33.68 / $33.68	Facility	26	$33.68	$33.68	$33.68
BCBS Facility/Professional Professional Modifier Low / Median / High Price $189.26 / $315.31 / $382.43	Professional		$189.26	$315.31	$382.43
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.88 / $115.10 / $139.60	Professional	26	$69.88	$115.10	$139.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $139.09 / $200.21 / $242.83	Professional	TC	$139.09	$200.21	$242.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.54 / $139.75 / $336.18	Facility	26	$89.54	$139.75	$336.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.95 / $216.83 / $512.46	Professional		$165.95	$216.83	$512.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.38 / $76.05 / $132.49	Professional	26	$46.38	$76.05	$132.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.24 / $140.33 / $378.32	Professional	TC	$105.24	$140.33	$378.32
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $77.59 / $123.21 / $264.70	Facility	26	$77.59	$123.21	$264.70
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $165.95 / $217.39 / $474.15	Professional		$165.95	$217.39	$474.15
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $59.89 / $74.86 / $120.89	Professional	26	$59.89	$74.86	$120.89
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $106.07 / $137.00 / $364.44	Professional	TC	$106.07	$137.00	$364.44
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $376.16 / $376.16 / $376.16	Facility	26	$376.16	$376.16	$376.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.29 / $250.49 / $1,267.82	Professional		$117.29	$250.49	$1,267.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $60.89 / $103.19 / $330.65	Professional	26	$60.89	$103.19	$330.65
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $80.98 / $147.24 / $1,108.00	Professional	TC	$80.98	$147.24	$1,108.00
United Facility/Professional Professional Modifier Low / Median / High Price $118.08 / $223.55 / $389.15	Professional		$118.08	$223.55	$389.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $76.95 / $145.38	Professional	26	$43.67	$76.95	$145.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.62 / $135.77 / $245.10	Professional	TC	$73.62	$135.77	$245.10