Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.45 / $13.45 / $13.45	Facility	26	$13.45	$13.45	$13.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.06 / $31.06 / $31.06	Facility	TC	$31.06	$31.06	$31.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.64 / $41.40 / $63.58	Professional		$34.64	$41.40	$63.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.15 / $13.18 / $20.86	Professional	26	$11.15	$13.18	$20.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.85 / $26.27 / $43.58	Professional	TC	$22.85	$26.27	$43.58
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.94 / $10.94 / $10.94	Facility	26	$10.94	$10.94	$10.94
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.33 / $25.33 / $25.33	Facility	TC	$25.33	$25.33	$25.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $122.83 / $148.97	Professional		$73.70	$122.83	$148.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $37.72 / $45.75	Professional	26	$22.71	$37.72	$45.75
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $59.60 / $85.11 / $103.23	Professional	TC	$59.60	$85.11	$103.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.21 / $44.40 / $109.19	Facility	26	$26.21	$44.40	$109.19
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $61.39 / $103.99 / $255.73	Facility	TC	$61.39	$103.99	$255.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $81.20 / $135.94	Professional		$43.71	$81.20	$135.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.69 / $24.49 / $41.00	Professional	26	$15.69	$24.49	$41.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.38 / $56.72 / $93.88	Professional	TC	$28.38	$56.72	$93.88
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $23.34 / $40.02 / $85.98	Facility	26	$23.34	$40.02	$85.98
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $54.66 / $93.73 / $201.36	Facility	TC	$54.66	$93.73	$201.36
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $63.95 / $75.69 / $129.09	Professional		$63.95	$75.69	$129.09
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.29 / $22.83 / $38.93	Professional	26	$19.29	$22.83	$38.93
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $44.66 / $52.86 / $90.16	Professional	TC	$44.66	$52.86	$90.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.86 / $71.16 / $212.00	Professional		$41.86	$71.16	$212.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $25.21 / $81.06	Professional	26	$14.07	$25.21	$81.06
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $46.86 / $190.40	Professional	TC	$27.79	$46.86	$190.40
United Facility/Professional Professional Modifier Low / Median / High Price $40.75 / $67.09 / $129.62	Professional		$40.75	$67.09	$129.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.07 / $26.96 / $87.90	Professional	26	$14.07	$26.96	$87.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.79 / $44.90 / $84.73	Professional	TC	$27.79	$44.90	$84.73