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 / $52.25	Facility	26	$52.25	$52.25	$52.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $158.75 / $337.60	Professional		$134.40	$158.75	$337.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.10 / $57.78 / $170.05	Professional	26	$46.10	$57.78	$170.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $86.87 / $97.50 / $220.00	Professional	TC	$86.87	$97.50	$220.00
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 $245.52 / $409.13 / $496.22	Professional		$245.52	$409.13	$496.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $88.94 / $147.02 / $178.31	Professional	26	$88.94	$147.02	$178.31
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $182.92 / $262.12 / $317.91	Professional	TC	$182.92	$262.12	$317.91
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 $172.55 / $271.99 / $549.07	Professional		$172.55	$271.99	$549.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.58 / $96.68 / $164.18	Professional	26	$59.58	$96.68	$164.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.73 / $175.31 / $368.08	Professional	TC	$112.73	$175.31	$368.08
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 $214.17 / $266.37 / $494.25	Professional		$214.17	$266.37	$494.25
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $76.13 / $93.47 / $153.68	Professional	26	$76.13	$93.47	$153.68
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $171.69 / $364.51	Professional	TC	$138.04	$171.69	$364.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $158.07 / $314.42 / $773.45	Professional		$158.07	$314.42	$773.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $58.55 / $112.62 / $279.32	Professional	26	$58.55	$112.62	$279.32
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $103.57 / $187.92 / $564.54	Professional	TC	$103.57	$187.92	$564.54
United Facility/Professional Professional Modifier Low / Median / High Price $150.62 / $259.92 / $506.36	Professional		$150.62	$259.92	$506.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.36 / $95.81 / $171.37	Professional	26	$54.36	$95.81	$171.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.33 / $176.07 / $327.45	Professional	TC	$94.33	$176.07	$327.45