Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $32.84 / $129.97 / $338.55	Facility		$32.84	$129.97	$338.55
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.19 / $8.19 / $13.92	Facility	26	$8.19	$8.19	$13.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.66 / $24.66 / $24.66	Facility	TC	$24.66	$24.66	$24.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $130.94	Professional		$22.39	$32.36	$130.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.22 / $34.38	Professional	26	$7.00	$8.22	$34.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.00 / $40.00 / $40.00	Professional	50	$40.00	$40.00	$40.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.53 / $16.19 / $31.16	Professional	52	$11.53	$16.19	$31.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $23.43 / $64.97	Professional	TC	$17.89	$23.43	$64.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $230.55 / $444.65	Facility		$137.93	$230.55	$444.65
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 $20.44 / $20.44 / $20.44	Facility	TC	$20.44	$20.44	$20.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $91.88 / $111.44	Professional		$54.74	$91.88	$111.44
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 $43.38 / $68.67 / $83.29	Professional	TC	$43.38	$68.67	$83.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.52 / $111.00 / $272.97	Facility		$65.52	$111.00	$272.97
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 $49.66 / $84.13 / $206.88	Facility	TC	$49.66	$84.13	$206.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.85 / $60.59 / $100.29	Professional		$30.85	$60.59	$100.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.88 / $14.82 / $25.02	Professional	26	$8.88	$14.82	$25.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.98 / $45.76 / $75.75	Professional	TC	$21.98	$45.76	$75.75
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $58.35 / $100.04 / $214.94	Facility		$58.35	$100.04	$214.94
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 $44.22 / $75.81 / $162.90	Facility	TC	$44.22	$75.81	$162.90
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $47.71 / $56.47 / $96.30	Professional		$47.71	$56.47	$96.30
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 $36.03 / $42.65 / $72.73	Professional	TC	$36.03	$42.65	$72.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.81 / $55.03 / $124.46	Facility		$29.81	$55.03	$124.46
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 $105.96 / $186.74 / $327.63	Facility	TC	$105.96	$186.74	$327.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.84 / $52.46 / $200.17	Professional		$29.84	$52.46	$200.17
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $16.42 / $61.09	Professional	26	$8.66	$16.42	$61.09
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $44.07 / $49.21 / $112.05	Professional	52	$44.07	$49.21	$112.05
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $35.44 / $154.00	Professional	TC	$20.92	$35.44	$154.00
United Facility/Professional Professional Modifier Low / Median / High Price $29.05 / $46.91 / $93.53	Professional		$29.05	$46.91	$93.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $14.96 / $27.10	Professional	26	$8.66	$14.96	$27.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.69 / $32.38 / $68.18	Professional	TC	$20.69	$32.38	$68.18