Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $263.03 / $416.87	Facility		$134.90	$263.03	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $14.45	Facility	26	$7.94	$7.94	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $19.95 / $60.26	Facility	TC	$19.95	$19.95	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $36.31 / $112.20	Professional		$22.91	$36.31	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $11.22 / $35.48	Professional	26	$7.59	$11.22	$35.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $22.91 / $72.44	Professional	TC	$15.14	$22.91	$72.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $263.03 / $758.58	Facility		$144.54	$263.03	$758.58
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $6.17 / $7.08 / $7.08	Facility	26	$6.17	$7.08	$7.08
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $15.14 / $17.38 / $17.38	Facility	TC	$15.14	$17.38	$17.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $100.00	Professional		$45.71	$67.61	$100.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $29.51	Professional	26	$13.80	$19.95	$29.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $48.98 / $70.79	Professional	TC	$32.36	$48.98	$70.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $104.71 / $251.19	Facility		$64.57	$104.71	$251.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $26.30 / $72.44	Facility	26	$6.76	$26.30	$72.44
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $15.14 / $64.57 / $177.83	Facility	TC	$15.14	$64.57	$177.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $53.70 / $87.10	Professional		$29.51	$53.70	$87.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.49 / $25.12	Professional	26	$9.12	$15.49	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $38.02 / $61.66	Professional	TC	$20.42	$38.02	$61.66
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $81.28 / $100.00 / $194.98	Facility		$81.28	$100.00	$194.98
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $28.84 / $56.23	Facility	26	$23.44	$28.84	$56.23
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $57.54 / $70.79 / $138.04	Facility	TC	$57.54	$70.79	$138.04
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $41.69 / $69.18	Professional		$41.69	$41.69	$69.18
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $19.05	Professional	26	$12.30	$12.30	$19.05
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $30.20 / $46.77	Professional	TC	$30.20	$30.20	$46.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $83.18 / $275.42	Facility		$33.88	$83.18	$275.42
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 $158.49 / $199.53 / $288.40	Facility	TC	$158.49	$199.53	$288.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $63.10 / $177.83	Professional		$28.18	$63.10	$177.83
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $20.89 / $77.62	Professional	26	$10.23	$20.89	$77.62
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $37.15 / $162.18	Professional	TC	$19.05	$37.15	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $269.15 / $363.08	Facility		$263.03	$269.15	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $50.12 / $87.10	Professional		$27.54	$50.12	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $14.79 / $25.70	Professional	26	$8.71	$14.79	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $35.48 / $60.26	Professional	TC	$19.05	$35.48	$60.26