Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $22.91	Facility	26	$12.88	$12.88	$22.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $74.13 / $229.09	Professional		$44.67	$74.13	$229.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $23.99 / $52.48	Professional	26	$12.02	$23.99	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $125.89	Professional	TC	$32.36	$48.98	$125.89
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.55 / $10.96 / $10.96	Facility	26	$9.55	$10.96	$10.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $128.82 / $194.98	Professional		$89.13	$128.82	$194.98
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $31.62 / $46.77	Professional	26	$21.38	$31.62	$46.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $102.33 / $147.91	Professional	TC	$67.61	$102.33	$147.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.72 / $40.74 / $112.20	Facility	26	$10.72	$40.74	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $95.50 / $165.96	Professional		$53.70	$95.50	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $24.55 / $38.90	Professional	26	$15.85	$24.55	$38.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $74.13 / $128.82	Professional	TC	$38.02	$74.13	$128.82
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $44.67 / $87.10	Facility	26	$35.48	$44.67	$87.10
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $83.18 / $128.82	Professional		$83.18	$83.18	$128.82
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $19.50 / $33.11	Professional	26	$19.50	$19.50	$33.11
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $63.10 / $100.00	Professional	TC	$63.10	$63.10	$100.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $109.65 / $109.65 / $109.65	Facility	26	$109.65	$109.65	$109.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $109.65 / $346.74	Professional		$51.29	$109.65	$346.74
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $29.51 / $114.82	Professional	26	$15.14	$29.51	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $58.88 / $257.04	Professional	TC	$35.48	$58.88	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $162.18	Professional		$50.12	$79.43	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $24.55 / $40.74	Professional	26	$14.13	$24.55	$40.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $54.95 / $123.03	Professional	TC	$35.48	$54.95	$123.03