Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $52.48 / $89.13	Facility	26	$47.86	$52.48	$89.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $223.87 / $851.14	Professional		$120.23	$223.87	$851.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $54.95 / $181.97	Professional	26	$46.77	$54.95	$181.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	52	$69.18	$69.18	$69.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $123.03 / $398.11	Professional	TC	$79.43	$123.03	$398.11
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $42.66 / $42.66	Facility	26	$37.15	$42.66	$42.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $323.59 / $478.63	Professional		$223.87	$323.59	$478.63
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $123.03 / $181.97	Professional	26	$83.18	$123.03	$181.97
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $229.09 / $229.09 / $229.09	Professional	52	$229.09	$229.09	$229.09
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $208.93 / $302.00	Professional	TC	$138.04	$208.93	$302.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $162.18 / $446.68	Facility	26	$41.69	$162.18	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $263.03 / $524.81	Professional		$194.98	$263.03	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $97.72 / $162.18	Professional	26	$56.23	$97.72	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $165.96 / $363.08	Professional	TC	$125.89	$165.96	$363.08
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $144.54 / $181.97 / $354.81	Facility	26	$144.54	$181.97	$354.81
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $446.68	Professional		$208.93	$208.93	$446.68
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $75.86 / $134.90	Professional	26	$75.86	$75.86	$134.90
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $131.83 / $323.59	Professional	TC	$131.83	$131.83	$323.59
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $478.63 / $478.63 / $478.63	Facility	26	$478.63	$478.63	$478.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $398.11 / $1,621.81	Professional		$177.83	$398.11	$1,621.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $134.90 / $436.52	Professional	26	$70.79	$134.90	$436.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $234.42 / $1,380.38	Professional	TC	$102.33	$234.42	$1,380.38
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $309.03 / $489.78	Professional		$162.18	$309.03	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $165.96	Professional	26	$56.23	$89.13	$165.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $204.17 / $323.59	Professional	TC	$102.33	$204.17	$323.59