Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.25 / $52.25 / $88.82	Facility	26	$52.25	$52.25	$88.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.00 / $221.75 / $913.76	Professional		$132.00	$221.75	$913.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.98 / $68.84 / $161.90	Professional	26	$45.98	$68.84	$161.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $60.17 / $81.52 / $137.50	Professional	52	$60.17	$81.52	$137.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.42 / $171.09 / $257.52	Professional	TC	$82.42	$171.09	$257.52
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $42.90 / $42.90 / $42.90	Facility	26	$42.90	$42.90	$42.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $235.85 / $395.60 / $479.80	Professional		$235.85	$395.60	$479.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.52 / $147.02 / $178.31	Professional	26	$88.52	$147.02	$178.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $171.51 / $248.58 / $301.49	Professional	TC	$171.51	$248.58	$301.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.03 / $177.97 / $428.13	Facility	26	$114.03	$177.97	$428.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.06 / $274.69 / $547.33	Professional		$207.06	$274.69	$547.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.49 / $96.68 / $165.96	Professional	26	$60.49	$96.68	$165.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.94 / $180.05 / $410.59	Professional	TC	$130.94	$180.05	$410.59
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $98.82 / $156.91 / $337.11	Facility	26	$98.82	$156.91	$337.11
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $207.06 / $271.24 / $534.49	Professional		$207.06	$271.24	$534.49
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $76.13 / $92.84 / $153.68	Professional	26	$76.13	$92.84	$153.68
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $130.94 / $171.52 / $374.10	Professional	TC	$130.94	$171.52	$374.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $479.84 / $479.84 / $479.84	Facility	26	$479.84	$479.84	$479.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.72 / $375.37 / $1,609.32	Professional		$192.72	$375.37	$1,609.32
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $66.56 / $126.32 / $394.61	Professional	26	$66.56	$126.32	$394.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $111.55 / $235.52 / $1,384.00	Professional	TC	$111.55	$235.52	$1,384.00
United Facility/Professional Professional Modifier Low / Median / High Price $160.60 / $293.89 / $534.67	Professional		$160.60	$293.89	$534.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.32 / $94.11 / $180.46	Professional	26	$56.32	$94.11	$180.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $101.41 / $202.44 / $342.55	Professional	TC	$101.41	$202.44	$342.55