Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.27 / $289.29 / $556.03	Facility		$88.27	$289.29	$556.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.86 / $10.64 / $17.98	Facility	26	$9.86	$10.64	$17.98
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.66 / $253.50 / $358.78	Facility	TC	$24.66	$253.50	$358.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.58 / $37.02 / $195.70	Professional		$27.58	$37.02	$195.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $17.98 / $57.95	Professional	26	$9.69	$17.98	$57.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.92 / $24.57 / $147.00	Professional	TC	$17.92	$24.57	$147.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $132.79 / $232.87 / $433.00	Facility		$132.79	$232.87	$433.00
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.64 / $8.64 / $8.64	Facility	26	$8.64	$8.64	$8.64
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $20.44 / $20.44 / $20.44	Facility	TC	$20.44	$20.44	$20.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.82 / $97.69 / $118.48	Professional		$58.82	$97.69	$118.48
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.05 / $29.99 / $36.36	Professional	26	$18.05	$29.99	$36.36
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.96 / $67.70 / $82.12	Professional	TC	$47.96	$67.70	$82.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.66 / $118.01 / $290.20	Facility		$69.66	$118.01	$290.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.69 / $35.04 / $86.20	Facility	26	$20.69	$35.04	$86.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $48.97 / $82.96 / $204.01	Facility	TC	$48.97	$82.96	$204.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.13 / $65.09 / $110.44	Professional		$34.13	$65.09	$110.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.15 / $19.34 / $33.19	Professional	26	$12.15	$19.34	$33.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.35 / $45.76 / $75.75	Professional	TC	$22.35	$45.76	$75.75
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $62.03 / $106.36 / $228.51	Facility		$62.03	$106.36	$228.51
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $18.43 / $31.59 / $67.88	Facility	26	$18.43	$31.59	$67.88
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $43.61 / $74.77 / $160.63	Facility	TC	$43.61	$74.77	$160.63
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $51.26 / $60.67 / $103.47	Professional		$51.26	$60.67	$103.47
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $15.23 / $18.02 / $30.74	Professional	26	$15.23	$18.02	$30.74
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $36.03 / $42.65 / $72.73	Professional	TC	$36.03	$42.65	$72.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.25 / $150.40 / $324.00	Facility		$58.25	$150.40	$324.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $197.40 / $275.39 / $377.95	Facility	TC	$197.40	$275.39	$377.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.35 / $93.43 / $199.28	Professional		$38.35	$93.43	$199.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $17.79 / $28.20 / $60.78	Professional	26	$17.79	$28.20	$60.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $21.80 / $38.79 / $149.15	Professional	TC	$21.80	$38.79	$149.15
United Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $52.28 / $102.80	Professional		$31.63	$52.28	$102.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.19 / $21.82 / $87.90	Professional	26	$11.19	$21.82	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.01 / $43.14 / $118.87	Professional	TC	$22.01	$43.14	$118.87