Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.10 / $275.42 / $489.78	Facility		$87.10	$275.42	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.77 / $10.00 / $18.20	Facility	26	$9.77	$10.00	$18.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $151.36 / $302.00	Facility	TC	$23.99	$151.36	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $50.12 / $169.82	Professional		$28.84	$50.12	$169.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $15.49 / $51.29	Professional	26	$9.55	$15.49	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $31.62 / $79.43	Professional	TC	$19.05	$31.62	$79.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $436.52 / $478.63	Facility		$165.96	$436.52	$478.63
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $8.51 / $8.51	Facility	26	$7.41	$8.51	$8.51
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $20.89 / $20.89	Facility	TC	$18.20	$20.89	$20.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $83.18 / $120.23	Professional		$57.54	$83.18	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $25.12 / $37.15	Professional	26	$17.78	$25.12	$37.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $60.26 / $83.18	Professional	TC	$41.69	$60.26	$83.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $123.03 / $302.00	Facility		$53.70	$123.03	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $33.11 / $89.13	Facility	26	$8.51	$33.11	$89.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $18.20 / $77.62 / $213.80	Facility	TC	$18.20	$77.62	$213.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $107.15	Professional		$33.88	$64.57	$107.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $19.50 / $31.62	Professional	26	$11.75	$19.50	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $44.67 / $72.44	Professional	TC	$21.88	$44.67	$72.44
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $120.23 / $239.88	Facility		$97.72	$120.23	$239.88
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $36.31 / $70.79	Facility	26	$28.84	$36.31	$70.79
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $69.18 / $85.11 / $165.96	Facility	TC	$69.18	$85.11	$165.96
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $91.20	Professional		$51.29	$51.29	$91.20
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $15.14 / $28.18	Professional	26	$15.14	$15.14	$28.18
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $36.31 / $60.26	Professional	TC	$36.31	$36.31	$60.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $177.83 / $338.84	Facility		$77.62	$177.83	$338.84
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $199.53 / $281.84 / $407.38	Facility	TC	$199.53	$281.84	$407.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $95.50 / $204.17	Professional		$38.02	$95.50	$204.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $30.20 / $61.66	Professional	26	$19.50	$30.20	$61.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $39.81 / $147.91	Professional	TC	$20.89	$39.81	$147.91
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $223.87 / $302.00	Facility		$218.78	$223.87	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $102.33	Professional		$31.62	$52.48	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $18.62 / $32.36	Professional	26	$10.96	$18.62	$32.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $33.88 / $70.79	Professional	TC	$20.89	$33.88	$70.79