Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.96 / $284.95 / $600.21	Facility		$118.96	$284.95	$600.21
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.91 / $8.53 / $14.51	Facility	26	$7.91	$8.53	$14.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.35 / $122.40 / $552.50	Facility	TC	$30.35	$122.40	$552.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.00 / $41.14 / $176.70	Professional		$16.00	$41.14	$176.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $13.18 / $42.72	Professional	26	$7.33	$13.18	$42.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $13.50 / $104.10 / $114.57	Professional	50	$13.50	$104.10	$114.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.64 / $31.37 / $151.19	Professional	TC	$21.64	$31.37	$151.19
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 $6.90 / $6.90 / $6.90	Facility	26	$6.90	$6.90	$6.90
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.33 / $25.33 / $25.33	Facility	TC	$25.33	$25.33	$25.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.22 / $108.33 / $131.38	Professional		$65.22	$108.33	$131.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $24.18 / $29.33	Professional	26	$14.56	$24.18	$29.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $84.15 / $102.06	Professional	TC	$53.64	$84.15	$102.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.25 / $130.87 / $321.82	Facility		$77.25	$130.87	$321.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $28.04 / $68.95	Facility	26	$16.55	$28.04	$68.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $60.70 / $102.82 / $252.86	Facility	TC	$60.70	$102.82	$252.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $72.19 / $119.49	Professional		$34.70	$72.19	$119.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $15.47 / $26.11	Professional	26	$9.27	$15.47	$26.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.16 / $56.72 / $93.88	Professional	TC	$25.16	$56.72	$93.88
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $68.79 / $117.95 / $253.40	Facility		$68.79	$117.95	$253.40
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $14.74 / $25.27 / $54.30	Facility	26	$14.74	$25.27	$54.30
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $54.05 / $92.67 / $199.10	Facility	TC	$54.05	$92.67	$199.10
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $56.84 / $67.28 / $114.74	Professional		$56.84	$67.28	$114.74
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $14.42 / $24.59	Professional	26	$12.18	$14.42	$24.59
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $44.66 / $52.86 / $90.16	Professional	TC	$44.66	$52.86	$90.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $110.40 / $270.88	Facility		$41.02	$110.40	$270.88
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 $191.23 / $252.70 / $361.65	Facility	TC	$191.23	$252.70	$361.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $84.60 / $178.87	Professional		$35.36	$84.60	$178.87
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $20.44 / $46.99	Professional	26	$10.54	$20.44	$46.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.71 / $44.06 / $181.68	Professional	TC	$25.71	$44.06	$181.68
United Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $53.93 / $107.84	Professional		$33.60	$53.93	$107.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.85 / $15.37 / $27.50	Professional	26	$8.85	$15.37	$27.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.69 / $41.37 / $86.69	Professional	TC	$24.69	$41.37	$86.69