Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.69 / $206.99 / $425.82	Facility		$35.69	$206.99	$425.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.19 / $8.19 / $12.28	Facility	26	$8.19	$8.19	$12.28
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $19.95 / $27.50 / $27.50	Facility	TC	$19.95	$27.50	$27.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $35.69 / $165.30	Professional		$23.03	$35.69	$165.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.69 / $34.88	Professional	26	$7.00	$8.69	$34.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $92.36 / $120.00 / $120.00	Professional	50	$92.36	$120.00	$120.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.52 / $17.30 / $33.81	Professional	52	$12.52	$17.30	$33.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.07 / $25.03 / $55.10	Professional	TC	$20.07	$25.03	$55.10
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.59 / $202.67 / $400.03	Facility		$117.59	$202.67	$400.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $6.61 / $6.61	Facility	26	$6.61	$6.61	$6.61
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 $58.82 / $98.66 / $119.66	Professional		$58.82	$98.66	$119.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $23.21 / $28.15	Professional	26	$13.97	$23.21	$28.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $49.36 / $75.44 / $91.50	Professional	TC	$49.36	$75.44	$91.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.34 / $119.18 / $293.08	Facility		$70.34	$119.18	$293.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $26.87 / $66.09	Facility	26	$15.86	$26.87	$66.09
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 $32.33 / $65.09 / $107.75	Professional		$32.33	$65.09	$107.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.09 / $14.82 / $25.02	Professional	26	$9.09	$14.82	$25.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.05 / $50.27 / $83.22	Professional	TC	$23.05	$50.27	$83.22
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $62.65 / $107.42 / $230.78	Facility		$62.65	$107.42	$230.78
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $24.22 / $52.04	Facility	26	$14.13	$24.22	$52.04
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 $51.26 / $60.67 / $103.47	Professional		$51.26	$60.67	$103.47
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $13.82 / $23.56	Professional	26	$11.67	$13.82	$23.56
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 $33.76 / $60.85 / $190.97	Facility		$33.76	$60.85	$190.97
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 $132.46 / $188.85 / $315.45	Facility	TC	$132.46	$188.85	$315.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.10 / $59.23 / $217.55	Professional		$33.10	$59.23	$217.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $16.54 / $59.45	Professional	26	$8.66	$16.54	$59.45
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $50.01 / $56.88 / $117.45	Professional	52	$50.01	$56.88	$117.45
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.57 / $39.71 / $166.53	Professional	TC	$23.57	$39.71	$166.53
United Facility/Professional Professional Modifier Low / Median / High Price $31.54 / $52.08 / $101.22	Professional		$31.54	$52.08	$101.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $14.31 / $26.40	Professional	26	$8.66	$14.31	$26.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.31 / $37.61 / $75.98	Professional	TC	$23.31	$37.61	$75.98