Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.80 / $264.41 / $440.73	Facility		$100.80	$264.41	$440.73
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.58 / $8.19 / $13.92	Facility	26	$7.58	$8.19	$13.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.86 / $27.86 / $313.52	Facility	TC	$27.86	$27.86	$313.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.55 / $36.04 / $141.22	Professional		$12.55	$36.04	$141.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.19 / $11.40 / $43.20	Professional	26	$7.19	$11.40	$43.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $40.00 / $187.88 / $252.00	Professional	50	$40.00	$187.88	$252.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.64 / $16.78 / $25.58	Professional	52	$12.64	$16.78	$25.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $26.77 / $75.65	Professional	TC	$19.46	$26.77	$75.65
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 $6.61 / $6.61 / $6.61	Facility	26	$6.61	$6.61	$6.61
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.75 / $22.75 / $22.75	Facility	TC	$22.75	$22.75	$22.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $99.62 / $120.83	Professional		$59.40	$99.62	$120.83
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 $48.27 / $76.41 / $92.67	Professional	TC	$48.27	$76.41	$92.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.04 / $120.35 / $295.95	Facility		$71.04	$120.35	$295.95
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 $55.18 / $93.48 / $229.87	Facility	TC	$55.18	$93.48	$229.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.63 / $65.73 / $108.82	Professional		$33.63	$65.73	$108.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.49 / $14.82 / $25.02	Professional	26	$9.49	$14.82	$25.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.94 / $50.92 / $84.28	Professional	TC	$23.94	$50.92	$84.28
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $63.26 / $108.47 / $233.04	Facility		$63.26	$108.47	$233.04
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 $49.14 / $84.25 / $181.00	Facility	TC	$49.14	$84.25	$181.00
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $61.27 / $104.50	Professional		$51.77	$61.27	$104.50
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 $40.09 / $47.46 / $80.94	Professional	TC	$40.09	$47.46	$80.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.20 / $85.51 / $275.08	Facility		$38.20	$85.51	$275.08
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 $169.58 / $244.03 / $357.34	Facility	TC	$169.58	$244.03	$357.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.92 / $71.36 / $219.71	Professional		$33.92	$71.36	$219.71
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $9.94 / $19.46 / $42.93	Professional	26	$9.94	$19.46	$42.93
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.00 / $42.15 / $168.70	Professional	TC	$25.00	$42.15	$168.70
United Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $52.96 / $105.03	Professional		$32.22	$52.96	$105.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $15.60 / $86.60	Professional	26	$8.66	$15.60	$86.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.00 / $42.15 / $77.01	Professional	TC	$25.00	$42.15	$77.01