Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.50 / $14.50 / $14.50	Facility	26	$14.50	$14.50	$14.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $42.08 / $42.08 / $348.05	Facility	TC	$42.08	$42.08	$348.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $54.25 / $215.20	Professional		$44.14	$54.25	$215.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.28 / $14.50 / $39.15	Professional	26	$12.28	$14.50	$39.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.85 / $38.39 / $82.09	Professional	TC	$30.85	$38.39	$82.09
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $11.80 / $11.80 / $11.80	Facility	26	$11.80	$11.80	$11.80
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $35.11 / $35.11 / $35.11	Facility	TC	$35.11	$35.11	$35.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $156.69 / $190.04	Professional		$94.34	$156.69	$190.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.45 / $40.61 / $49.27	Professional	26	$24.45	$40.61	$49.27
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.38 / $116.06 / $140.77	Professional	TC	$77.38	$116.06	$140.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.28 / $47.91 / $117.81	Facility	26	$28.28	$47.91	$117.81
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $84.15 / $142.55 / $350.55	Facility	TC	$84.15	$142.55	$350.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.13 / $105.06 / $175.86	Professional		$55.13	$105.06	$175.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.80 / $26.43 / $44.23	Professional	26	$16.80	$26.43	$44.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.38 / $78.63 / $130.16	Professional	TC	$38.38	$78.63	$130.16
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.18 / $43.18 / $92.76	Facility	26	$25.18	$43.18	$92.76
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $74.93 / $128.47 / $276.02	Facility	TC	$74.93	$128.47	$276.02
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $82.72 / $97.91 / $166.99	Professional		$82.72	$97.91	$166.99
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $20.81 / $24.63 / $42.00	Professional	26	$20.81	$24.63	$42.00
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $61.92 / $73.29 / $124.99	Professional	TC	$61.92	$73.29	$124.99
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $287.81 / $355.45 / $411.70	Facility	TC	$287.81	$355.45	$411.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.69 / $96.63 / $273.42	Professional		$52.69	$96.63	$273.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $28.37 / $77.00	Professional	26	$15.16	$28.37	$77.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $37.53 / $63.71 / $255.46	Professional	TC	$37.53	$63.71	$255.46
United Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $96.39 / $171.41	Professional		$51.25	$96.39	$171.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.16 / $25.55 / $46.94	Professional	26	$15.16	$25.55	$46.94
United Facility/Professional Professional Modifier TC Low / Median / High Price $35.89 / $61.92 / $116.21	Professional	TC	$35.89	$61.92	$116.21