Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.55 / $295.05 / $513.29	Facility		$62.55	$295.05	$513.29
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.19 / $10.99 / $18.57	Facility	26	$10.19	$10.99	$18.57
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.60 / $30.70 / $313.52	Facility	TC	$28.60	$30.70	$313.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $43.06 / $165.00	Professional		$33.60	$43.06	$165.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.65 / $14.58 / $46.06	Professional	26	$9.65	$14.58	$46.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $30.70 / $77.40	Professional	TC	$23.46	$30.70	$77.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.59 / $202.67 / $400.03	Facility		$117.59	$202.67	$400.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.92 / $8.92 / $8.92	Facility	26	$8.92	$8.92	$8.92
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.33 / $25.33 / $25.33	Facility	TC	$25.33	$25.33	$25.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.30 / $115.10 / $139.60	Professional		$69.30	$115.10	$139.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.63 / $30.95 / $37.54	Professional	26	$18.63	$30.95	$37.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $84.15 / $102.06	Professional	TC	$53.64	$84.15	$102.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $82.08 / $139.04 / $341.93	Facility		$82.08	$139.04	$341.93
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $36.22 / $89.07	Facility	26	$21.38	$36.22	$89.07
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $60.70 / $102.82 / $252.86	Facility	TC	$60.70	$102.82	$252.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.33 / $76.70 / $126.96	Professional		$39.33	$76.70	$126.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.81 / $19.98 / $33.72	Professional	26	$11.81	$19.98	$33.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.29 / $56.72 / $93.88	Professional	TC	$27.29	$56.72	$93.88
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $73.09 / $125.32 / $269.24	Facility		$73.09	$125.32	$269.24
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $19.04 / $32.65 / $70.14	Facility	26	$19.04	$32.65	$70.14
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $54.05 / $92.67 / $199.10	Facility	TC	$54.05	$92.67	$199.10
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $60.39 / $71.48 / $121.92	Professional		$60.39	$71.48	$121.92
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $18.62 / $31.76	Professional	26	$15.73	$18.62	$31.76
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $44.66 / $52.86 / $90.16	Professional	TC	$44.66	$52.86	$90.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.33 / $91.86 / $308.70	Facility		$42.33	$91.86	$308.70
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $204.56 / $280.89 / $448.45	Facility	TC	$204.56	$280.89	$448.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $88.57 / $229.20	Professional		$38.61	$88.57	$229.20
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $24.87 / $60.42	Professional	26	$12.78	$24.87	$60.42
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.50 / $43.46 / $195.00	Professional	TC	$26.50	$43.46	$195.00
United Facility/Professional Professional Modifier Low / Median / High Price $36.69 / $61.41 / $124.11	Professional		$36.69	$61.41	$124.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $20.34 / $35.21	Professional	26	$11.55	$20.34	$35.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.72 / $40.45 / $82.53	Professional	TC	$25.72	$40.45	$82.53