Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.45 / $256.50 / $625.50	Facility		$37.45	$256.50	$625.50
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.89 / $8.89 / $15.11	Facility	26	$8.89	$8.89	$15.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.57 / $28.57 / $276.25	Facility	TC	$28.57	$28.57	$276.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.97 / $35.54 / $134.30	Professional		$9.97	$35.54	$134.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.82 / $9.32 / $38.22	Professional	26	$7.82	$9.32	$38.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.96 / $25.44 / $51.92	Professional	TC	$20.96	$25.44	$51.92
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 $7.20 / $7.20 / $7.20	Facility	26	$7.20	$7.20	$7.20
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $23.61 / $23.61 / $23.61	Facility	TC	$23.61	$23.61	$23.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.31 / $103.49 / $125.52	Professional		$62.31	$103.49	$125.52
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $25.15 / $30.50	Professional	26	$15.14	$25.15	$30.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.42 / $78.34 / $95.02	Professional	TC	$54.42	$78.34	$95.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.80 / $125.02 / $307.45	Facility		$73.80	$125.02	$307.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.23 / $29.21 / $71.83	Facility	26	$17.23	$29.21	$71.83
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $56.56 / $95.81 / $235.62	Facility	TC	$56.56	$95.81	$235.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $68.95 / $115.44	Professional		$36.65	$68.95	$115.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.58 / $16.11 / $26.97	Professional	26	$10.58	$16.11	$26.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.13 / $52.85 / $87.48	Professional	TC	$26.13	$52.85	$87.48
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $65.72 / $112.68 / $242.09	Facility		$65.72	$112.68	$242.09
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $15.36 / $26.33 / $56.56	Facility	26	$15.36	$26.33	$56.56
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $50.36 / $86.35 / $185.53	Facility	TC	$50.36	$86.35	$185.53
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $54.30 / $64.27 / $109.62	Professional		$54.30	$64.27	$109.62
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $12.69 / $15.02 / $25.61	Professional	26	$12.69	$15.02	$25.61
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $41.62 / $49.26 / $84.01	Professional	TC	$41.62	$49.26	$84.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.84 / $82.52 / $253.45	Facility		$37.84	$82.52	$253.45
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $159.32 / $222.37 / $326.48	Facility	TC	$159.32	$222.37	$326.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $62.62 / $201.81	Professional		$35.01	$62.62	$201.81
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.16 / $18.53 / $48.36	Professional	26	$10.16	$18.53	$48.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $43.49 / $170.86	Professional	TC	$25.63	$43.49	$170.86
United Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $59.33 / $106.74	Professional		$35.01	$59.33	$106.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.38 / $16.14 / $28.60	Professional	26	$9.38	$16.14	$28.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.63 / $42.23 / $78.14	Professional	TC	$25.63	$42.23	$78.14