Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.03 / $59.03 / $59.03	Facility	26	$59.03	$59.03	$59.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $170.07 / $275.00 / $358.35	Professional		$170.07	$275.00	$358.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.78 / $59.03 / $263.70	Professional	26	$52.78	$59.03	$263.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.43 / $217.25 / $282.18	Professional	TC	$112.43	$217.25	$282.18
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $48.37 / $48.37 / $48.37	Facility	26	$48.37	$48.37	$48.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.64 / $505.86 / $613.53	Professional		$301.64	$505.86	$613.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $100.16 / $166.36 / $201.77	Professional	26	$100.16	$166.36	$201.77
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $235.84 / $339.50 / $411.76	Professional	TC	$235.84	$339.50	$411.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.57 / $200.67 / $482.73	Facility	26	$128.57	$200.67	$482.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.92 / $341.74 / $633.11	Professional		$264.92	$341.74	$633.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.61 / $108.92 / $185.88	Professional	26	$65.61	$108.92	$185.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.15 / $240.03 / $459.29	Professional	TC	$179.15	$240.03	$459.29
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $111.42 / $176.92 / $380.10	Facility	26	$111.42	$176.92	$380.10
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $264.92 / $329.49 / $556.32	Professional		$264.92	$329.49	$556.32
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $85.77 / $105.30 / $173.14	Professional	26	$85.77	$105.30	$173.14
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $179.15 / $222.81 / $382.55	Professional	TC	$179.15	$222.81	$382.55
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $542.79 / $542.79 / $542.79	Facility	26	$542.79	$542.79	$542.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $219.93 / $415.00 / $1,884.77	Professional		$219.93	$415.00	$1,884.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $62.44 / $115.80 / $434.24	Professional	26	$62.44	$115.80	$434.24
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $151.25 / $295.62 / $1,950.00	Professional	TC	$151.25	$295.62	$1,950.00
United Facility/Professional Professional Modifier Low / Median / High Price $199.94 / $391.88 / $665.66	Professional		$199.94	$391.88	$665.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.44 / $109.08 / $196.16	Professional	26	$62.44	$109.08	$196.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.50 / $265.37 / $455.62	Professional	TC	$137.50	$265.37	$455.62