Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $223.87 / $416.87	Facility		$114.82	$223.87	$416.87
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.59 / $13.18	Facility	26	$7.08	$7.59	$13.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $21.88 / $104.71	Facility	TC	$21.88	$21.88	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $32.36 / $109.65	Professional		$10.72	$32.36	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.79 / $40.74	Professional	26	$7.08	$14.79	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $16.98 / $58.88 / $251.19	Professional	50	$16.98	$58.88	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $28.84 / $66.07	Professional	TC	$16.98	$28.84	$66.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $234.42 / $630.96	Facility		$138.04	$234.42	$630.96
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $5.62 / $6.46 / $6.46	Facility	26	$5.62	$6.46	$6.46
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $16.60 / $19.05 / $19.05	Facility	TC	$16.60	$19.05	$19.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $70.79 / $104.71	Professional		$47.86	$70.79	$104.71
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $18.62 / $27.54	Professional	26	$12.59	$18.62	$27.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $53.70 / $77.62	Professional	TC	$35.48	$53.70	$77.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.61 / $109.65 / $263.03	Facility		$67.61	$109.65	$263.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.31 / $23.99 / $66.07	Facility	26	$6.31	$23.99	$66.07
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $16.98 / $72.44 / $199.53	Facility	TC	$16.98	$72.44	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $52.48 / $89.13	Professional		$29.51	$52.48	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.13 / $22.91	Professional	26	$8.51	$14.13	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $40.74 / $69.18	Professional	TC	$20.89	$40.74	$69.18
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $104.71 / $208.93	Facility		$85.11	$104.71	$208.93
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $21.38 / $26.30 / $52.48	Facility	26	$21.38	$26.30	$52.48
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $64.57 / $79.43 / $154.88	Facility	TC	$64.57	$79.43	$154.88
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $44.67 / $69.18	Professional		$44.67	$44.67	$69.18
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.22 / $17.38	Professional	26	$11.22	$11.22	$17.38
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $33.88 / $52.48	Professional	TC	$33.88	$33.88	$52.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $117.49 / $257.04	Facility		$38.02	$117.49	$257.04
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 $162.18 / $223.87 / $331.13	Facility	TC	$162.18	$223.87	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $58.88 / $186.21	Professional		$27.54	$58.88	$186.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $19.50 / $61.66	Professional	26	$9.77	$19.50	$61.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $33.11 / $162.18	Professional	TC	$19.50	$33.11	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $223.87 / $302.00	Facility		$218.78	$223.87	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $44.67 / $89.13	Professional		$27.54	$44.67	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $13.80 / $24.55	Professional	26	$8.32	$13.80	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $31.62 / $64.57	Professional	TC	$19.50	$31.62	$64.57