Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $70.79 / $123.03	Facility	26	$66.07	$70.79	$123.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $426.58 / $1,513.56	Professional		$199.53	$426.58	$1,513.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $102.33 / $331.13	Professional	26	$66.07	$102.33	$331.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.72 / $147.91 / $363.08	Professional	52	$97.72	$147.91	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $251.19 / $549.54	Professional	TC	$128.82	$251.19	$549.54
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $58.88 / $58.88	Facility	26	$51.29	$58.88	$58.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $478.63 / $724.44	Professional		$331.13	$478.63	$724.44
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $165.96 / $251.19	Professional	26	$114.82	$165.96	$251.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $323.59 / $467.74	Professional	TC	$213.80	$323.59	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $223.87 / $616.60	Facility	26	$56.23	$223.87	$616.60
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.91 / $40.74 / $61.66	Facility	53	$22.91	$40.74	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $389.05 / $870.96	Professional		$288.40	$389.05	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $131.83 / $218.78	Professional	26	$75.86	$131.83	$218.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $257.04 / $660.69	Professional	TC	$194.98	$257.04	$660.69
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $194.98 / $245.47 / $478.63	Facility	26	$194.98	$245.47	$478.63
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $812.83	Professional		$309.03	$309.03	$812.83
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $162.18	Professional	26	$104.71	$104.71	$162.18
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $204.17 / $549.54	Professional	TC	$204.17	$204.17	$549.54
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $660.69 / $660.69 / $660.69	Facility	26	$660.69	$660.69	$660.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $575.44 / $2,884.03	Professional		$251.19	$575.44	$2,884.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $177.83 / $588.84	Professional	26	$93.33	$177.83	$588.84
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $630.96 / $1,230.27 / $1,862.09	Professional	52	$630.96	$1,230.27	$1,862.09
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $354.81 / $2,511.89	Professional	TC	$158.49	$354.81	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $446.68 / $758.58	Professional		$229.09	$446.68	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $125.89 / $229.09	Professional	26	$74.13	$125.89	$229.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $295.12 / $588.84	Professional	TC	$151.36	$295.12	$588.84