Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.50 / $41.50 / $70.54	Facility	26	$41.50	$41.50	$70.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.27 / $253.19 / $1,110.55	Professional		$128.27	$253.19	$1,110.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.11 / $55.00 / $156.60	Professional	26	$39.11	$55.00	$156.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $57.89 / $78.42 / $137.50	Professional	52	$57.89	$78.42	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.82 / $177.61 / $229.03	Professional	TC	$87.82	$177.61	$229.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $33.97 / $33.97 / $33.97	Facility	26	$33.97	$33.97	$33.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.11 / $381.08 / $462.20	Professional		$227.11	$381.08	$462.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.47 / $116.06 / $140.77	Professional	26	$70.47	$116.06	$140.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.86 / $265.02 / $321.43	Professional	TC	$182.86	$265.02	$321.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.31 / $140.94 / $339.06	Facility	26	$90.31	$140.94	$339.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.96 / $263.61 / $520.32	Professional		$199.96	$263.61	$520.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.14 / $76.70 / $133.62	Professional	26	$54.14	$76.70	$133.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $139.56 / $184.65 / $406.52	Professional	TC	$139.56	$184.65	$406.52
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $78.26 / $124.27 / $266.98	Facility	26	$78.26	$124.27	$266.98
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $199.96 / $258.27 / $508.26	Professional		$199.96	$258.27	$508.26
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $60.39 / $75.48 / $121.92	Professional	26	$60.39	$75.48	$121.92
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $139.56 / $180.26 / $364.51	Professional	TC	$139.56	$180.26	$364.51
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $379.28 / $379.28 / $379.28	Facility	26	$379.28	$379.28	$379.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $161.35 / $339.31 / $1,413.47	Professional		$161.35	$339.31	$1,413.47
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $52.84 / $94.14 / $333.52	Professional	26	$52.84	$94.14	$333.52
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $227.32 / $231.60 / $235.87	Professional	52	$227.32	$231.60	$235.87
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.18 / $194.40 / $1,220.00	Professional	TC	$107.18	$194.40	$1,220.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.47 / $254.49 / $470.99	Professional		$141.47	$254.49	$470.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.03 / $75.70 / $134.36	Professional	26	$44.03	$75.70	$134.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.44 / $177.43 / $329.06	Professional	TC	$97.44	$177.43	$329.06