Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $269.15 / $1,202.26	Facility		$42.66	$269.15	$1,202.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $18.62	Facility	26	$10.00	$10.00	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $32.36 / $54.95	Facility	TC	$32.36	$32.36	$54.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $51.29 / $138.04	Professional		$33.88	$51.29	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $15.14 / $38.90	Professional	26	$8.91	$15.14	$38.90
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $120.23 / $204.17	Professional	50	$26.92	$120.23	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.78 / $17.78 / $17.78	Professional	52	$17.78	$17.78	$17.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $32.36 / $74.13	Professional	TC	$23.99	$32.36	$74.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $263.03 / $758.58	Facility		$144.54	$263.03	$758.58
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $9.12 / $9.12	Facility	26	$7.94	$9.12	$9.12
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $27.54 / $27.54	Facility	TC	$23.99	$27.54	$27.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $100.00 / $147.91	Professional		$67.61	$100.00	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.70 / $38.02	Professional	26	$17.38	$25.70	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $75.86 / $109.65	Professional	TC	$50.12	$75.86	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $151.36 / $371.54	Facility		$64.57	$151.36	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.71 / $33.88 / $93.33	Facility	26	$8.71	$33.88	$93.33
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.99 / $102.33 / $281.84	Facility	TC	$23.99	$102.33	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $79.43 / $125.89	Professional		$42.66	$79.43	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $19.95 / $31.62	Professional	26	$12.59	$19.95	$31.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $58.88 / $95.50	Professional	TC	$30.90	$58.88	$95.50
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $295.12	Facility		$120.23	$147.91	$295.12
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $30.20 / $37.15 / $74.13	Facility	26	$30.20	$37.15	$74.13
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $91.20 / $112.20 / $218.78	Facility	TC	$91.20	$112.20	$218.78
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $97.72	Professional		$63.10	$63.10	$97.72
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $15.85 / $24.55	Professional	26	$15.85	$15.85	$24.55
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $46.77 / $74.13	Professional	TC	$46.77	$46.77	$74.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $85.11 / $295.12	Facility		$39.81	$85.11	$295.12
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $346.74 / $346.74 / $346.74	Facility	TC	$346.74	$346.74	$346.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $70.79 / $263.03	Professional		$38.02	$70.79	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $21.88 / $67.61	Professional	26	$11.48	$21.88	$67.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $48.98 / $194.98	Professional	TC	$27.54	$48.98	$194.98
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $269.15 / $363.08	Facility		$263.03	$269.15	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $67.61 / $125.89	Professional		$38.02	$67.61	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $19.50 / $33.88	Professional	26	$11.22	$19.50	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $48.98 / $93.33	Professional	TC	$27.54	$48.98	$93.33