Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.20 / $15.20 / $15.20	Facility	26	$15.20	$15.20	$15.20
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $33.54 / $33.54	Facility	TC	$33.54	$33.54	$33.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.88 / $44.39 / $69.79	Professional		$37.88	$44.39	$69.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.84 / $15.18 / $22.75	Professional	26	$12.84	$15.18	$22.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.51 / $27.10 / $47.07	Professional	TC	$23.51	$27.10	$47.07
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.37 / $12.37 / $12.37	Facility	26	$12.37	$12.37	$12.37
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	TC	$27.06	$27.06	$27.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.78 / $132.51 / $160.71	Professional		$79.78	$132.51	$160.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.62 / $41.59 / $50.44	Professional	26	$25.62	$41.59	$50.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.71 / $90.92 / $110.27	Professional	TC	$63.71	$90.92	$110.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.97 / $49.07 / $120.68	Facility	26	$28.97	$49.07	$120.68
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $65.52 / $111.00 / $272.97	Facility	TC	$65.52	$111.00	$272.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.93 / $88.30 / $147.80	Professional		$46.93	$88.30	$147.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.01 / $27.71 / $46.39	Professional	26	$18.01	$27.71	$46.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.18 / $60.59 / $100.29	Professional	TC	$29.18	$60.59	$100.29
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $44.23 / $95.03	Facility	26	$25.80	$44.23	$95.03
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $58.35 / $100.04 / $214.94	Facility	TC	$58.35	$100.04	$214.94
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $69.53 / $82.30 / $140.36	Professional		$69.53	$82.30	$140.36
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $21.82 / $25.83 / $44.05	Professional	26	$21.82	$25.83	$44.05
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $47.71 / $56.47 / $96.30	Professional	TC	$47.71	$56.47	$96.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $78.37 / $254.70	Professional		$45.47	$78.37	$254.70
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $29.43 / $93.99	Professional	26	$16.60	$29.43	$93.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.61 / $48.20 / $203.39	Professional	TC	$28.61	$48.20	$203.39
United Facility/Professional Professional Modifier Low / Median / High Price $45.47 / $76.25 / $138.63	Professional		$45.47	$76.25	$138.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $27.91 / $50.61	Professional	26	$16.60	$27.91	$50.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.43 / $46.82 / $91.71	Professional	TC	$27.43	$46.82	$91.71