Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.61 / $14.61 / $14.61	Facility	26	$14.61	$14.61	$14.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.91 / $65.59 / $111.56	Professional		$52.91	$65.59	$111.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $15.71 / $40.22	Professional	26	$12.28	$15.71	$40.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.02 / $49.12 / $71.52	Professional	TC	$39.02	$49.12	$71.52
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.80 / $11.80 / $11.80	Facility	26	$11.80	$11.80	$11.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.32 / $181.84 / $220.54	Professional		$108.32	$181.84	$220.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.04 / $41.59 / $50.44	Professional	26	$25.04	$41.59	$50.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $88.59 / $140.25 / $170.10	Professional	TC	$88.59	$140.25	$170.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.97 / $49.07 / $120.68	Facility	26	$28.97	$49.07	$120.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.95 / $121.17 / $200.57	Professional		$67.95	$121.17	$200.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.44 / $27.07 / $45.69	Professional	26	$18.44	$27.07	$45.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.44 / $94.10 / $157.51	Professional	TC	$48.44	$94.10	$157.51
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.80 / $44.23 / $95.03	Facility	26	$25.80	$44.23	$95.03
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $112.93 / $192.61	Professional		$95.41	$112.93	$192.61
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $21.32 / $25.23 / $43.03	Professional	26	$21.32	$25.23	$43.03
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $74.09 / $87.70 / $149.58	Professional	TC	$74.09	$87.70	$149.58
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $107.52 / $399.42	Professional		$60.27	$107.52	$399.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $30.96 / $137.04	Professional	26	$16.67	$30.96	$137.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.75 / $75.45 / $356.00	Professional	TC	$44.75	$75.45	$356.00
United Facility/Professional Professional Modifier Low / Median / High Price $60.27 / $100.68 / $183.75	Professional		$60.27	$100.68	$183.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.52 / $29.23 / $47.32	Professional	26	$15.52	$29.23	$47.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.17 / $71.15 / $136.43	Professional	TC	$44.17	$71.15	$136.43