Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.79 / $295.19 / $600.85	Facility		$64.79	$295.19	$600.85
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.57 / $9.24 / $257.48	Facility	26	$8.57	$9.24	$257.48
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.14 / $82.86 / $323.42	Facility	TC	$27.14	$82.86	$323.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.07 / $37.38 / $189.05	Professional		$14.07	$37.38	$189.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.56 / $13.61 / $43.24	Professional	26	$8.56	$13.61	$43.24
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $71.06 / $115.00	Professional	50	$19.27	$71.06	$115.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $27.46 / $175.50	Professional	TC	$19.14	$27.46	$175.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.10 / $202.67 / $400.03	Facility		$118.10	$202.67	$400.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $7.49 / $7.49 / $7.49	Facility	26	$7.49	$7.49	$7.49
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.46 / $22.46 / $22.46	Facility	TC	$22.46	$22.46	$22.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.56 / $101.56 / $123.18	Professional		$60.56	$101.56	$123.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $26.11 / $31.67	Professional	26	$15.73	$26.11	$31.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.28 / $75.44 / $91.50	Professional	TC	$49.28	$75.44	$91.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.42 / $122.69 / $301.70	Facility		$72.42	$122.69	$301.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.93 / $30.38 / $74.70	Facility	26	$17.93	$30.38	$74.70
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $54.49 / $92.31 / $227.00	Facility	TC	$54.49	$92.31	$227.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $67.03 / $110.95	Professional		$34.72	$67.03	$110.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.07 / $16.76 / $28.28	Professional	26	$10.07	$16.76	$28.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.27 / $50.27 / $83.22	Professional	TC	$24.27	$50.27	$83.22
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $64.48 / $110.58 / $237.56	Facility		$64.48	$110.58	$237.56
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $15.97 / $27.38 / $58.83	Facility	26	$15.97	$27.38	$58.83
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $48.52 / $83.19 / $178.74	Facility	TC	$48.52	$83.19	$178.74
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $52.78 / $62.47 / $106.55	Professional		$52.78	$62.47	$106.55
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $13.20 / $15.62 / $26.64	Professional	26	$13.20	$15.62	$26.64
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $39.59 / $46.85 / $79.91	Professional	TC	$39.59	$46.85	$79.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $108.38 / $307.08	Facility		$42.30	$108.38	$307.08
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 $183.58 / $266.98 / $357.34	Facility	TC	$183.58	$266.98	$357.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $86.34 / $203.04	Professional		$33.56	$86.34	$203.04
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.69 / $23.06 / $51.70	Professional	26	$11.69	$23.06	$51.70
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $30.00 / $30.00 / $30.00	Professional	50	$30.00	$30.00	$30.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.87 / $39.14 / $177.00	Professional	TC	$22.87	$39.14	$177.00
United Facility/Professional Professional Modifier Low / Median / High Price $32.24 / $52.76 / $107.05	Professional		$32.24	$52.76	$107.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $16.80 / $29.70	Professional	26	$9.74	$16.80	$29.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.32 / $36.75 / $72.73	Professional	TC	$22.32	$36.75	$72.73