Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.77 / $71.77 / $122.00	Facility	26	$71.77	$71.77	$122.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.72 / $459.79 / $1,222.20	Professional		$199.72	$459.79	$1,222.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.77 / $140.00 / $410.40	Professional	26	$71.77	$140.00	$410.40
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $101.43 / $125.00 / $300.00	Professional	52	$101.43	$125.00	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $128.72 / $294.39 / $383.84	Professional	TC	$128.72	$294.39	$383.84
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $58.74 / $58.74 / $58.74	Facility	26	$58.74	$58.74	$58.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $337.76 / $568.72 / $689.78	Professional		$337.76	$568.72	$689.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $121.71 / $201.18 / $244.00	Professional	26	$121.71	$201.18	$244.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $253.60 / $367.55 / $445.78	Professional	TC	$253.60	$367.55	$445.78
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $155.36 / $242.47 / $583.29	Facility	26	$155.36	$242.47	$583.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $296.38 / $399.97 / $995.62	Professional		$296.38	$399.97	$995.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.85 / $132.13 / $229.86	Professional	26	$85.85	$132.13	$229.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.34 / $264.02 / $765.58	Professional	TC	$192.34	$264.02	$765.58
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $134.63 / $213.78 / $459.29	Facility	26	$134.63	$213.78	$459.29
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $296.38 / $388.24 / $967.72	Professional		$296.38	$388.24	$967.72
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $104.04 / $132.57 / $210.02	Professional	26	$104.04	$132.57	$210.02
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $192.34 / $251.96 / $758.00	Professional	TC	$192.34	$251.96	$758.00
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $656.72 / $656.72 / $656.72	Facility	26	$656.72	$656.72	$656.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $264.61 / $528.94 / $2,901.82	Professional		$264.61	$528.94	$2,901.82
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $84.92 / $169.68 / $558.07	Professional	26	$84.92	$169.68	$558.07
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $335.00 / $335.00 / $606.38	Professional	52	$335.00	$335.00	$606.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $158.79 / $302.58 / $2,498.98	Professional	TC	$158.79	$302.58	$2,498.98
United Facility/Professional Professional Modifier Low / Median / High Price $220.51 / $410.22 / $734.14	Professional		$220.51	$410.22	$734.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.15 / $131.91 / $253.53	Professional	26	$76.15	$131.91	$253.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.36 / $285.14 / $521.33	Professional	TC	$144.36	$285.14	$521.33