Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $15.14 / $15.14	Facility	26	$15.14	$15.14	$15.14
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $33.11 / $33.11	Facility	TC	$33.11	$33.11	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $45.71 / $125.89	Professional		$36.31	$45.71	$125.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $15.85 / $52.48	Professional	26	$12.02	$15.85	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $29.51 / $61.66	Professional	TC	$22.91	$29.51	$61.66
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $12.30 / $12.30	Facility	26	$10.72	$12.30	$12.30
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $26.92 / $26.92	Facility	TC	$23.44	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $165.96	Professional		$77.62	$112.20	$165.96
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $52.48	Professional	26	$25.70	$36.31	$52.48
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $79.43 / $112.20	Professional	TC	$53.70	$79.43	$112.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.02 / $45.71 / $125.89	Facility	26	$12.02	$45.71	$125.89
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $104.71 / $288.40	Facility	TC	$23.99	$104.71	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $141.25	Professional		$45.71	$85.11	$141.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $27.54 / $43.65	Professional	26	$17.38	$27.54	$43.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $57.54 / $95.50	Professional	TC	$28.84	$57.54	$95.50
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $50.12 / $100.00	Facility	26	$40.74	$50.12	$100.00
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $114.82 / $223.87	Facility	TC	$91.20	$114.82	$223.87
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $69.18 / $109.65	Professional		$69.18	$69.18	$109.65
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $21.88 / $33.88	Professional	26	$21.88	$21.88	$33.88
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $47.86 / $74.13	Professional	TC	$47.86	$47.86	$74.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $295.12	Professional		$42.66	$72.44	$295.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $26.92 / $93.33	Professional	26	$15.85	$26.92	$93.33
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $44.67 / $204.17	Professional	TC	$26.30	$44.67	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $72.44 / $138.04	Professional		$43.65	$72.44	$138.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $27.54 / $47.86	Professional	26	$15.85	$27.54	$47.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $44.67 / $93.33	Professional	TC	$27.54	$44.67	$93.33