Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.18 / $301.29 / $526.22	Facility		$64.18	$301.29	$526.22
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.57 / $9.24 / $15.70	Facility	26	$8.57	$9.24	$15.70
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $132.54 / $323.42	Facility	TC	$33.54	$132.54	$323.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.32 / $45.39 / $199.50	Professional		$18.32	$45.39	$199.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.52 / $13.08 / $51.00	Professional	26	$8.52	$13.08	$51.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.27 / $75.41 / $249.00	Professional	50	$19.27	$75.41	$249.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.13 / $19.82 / $30.34	Professional	52	$15.13	$19.82	$30.34
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.44 / $33.54 / $171.00	Professional	TC	$24.44	$33.54	$171.00
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 $7.49 / $7.49 / $7.49	Facility	26	$7.49	$7.49	$7.49
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $27.63 / $27.63 / $27.63	Facility	TC	$27.63	$27.63	$27.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.04 / $118.97 / $144.29	Professional		$71.04	$118.97	$144.29
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.73 / $26.11 / $31.67	Professional	26	$15.73	$26.11	$31.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.66 / $92.86 / $112.62	Professional	TC	$58.66	$92.86	$112.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.84 / $143.72 / $353.43	Facility		$84.84	$143.72	$353.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.93 / $30.38 / $74.70	Facility	26	$17.93	$30.38	$74.70
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $66.90 / $113.34 / $278.72	Facility	TC	$66.90	$113.34	$278.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $78.63 / $130.16	Professional		$38.79	$78.63	$130.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.35 / $16.76 / $28.28	Professional	26	$10.35	$16.76	$28.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.49 / $61.87 / $102.42	Professional	TC	$28.49	$61.87	$102.42
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $75.55 / $129.53 / $278.29	Facility		$75.55	$129.53	$278.29
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $15.97 / $27.38 / $58.83	Facility	26	$15.97	$27.38	$58.83
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $59.58 / $102.15 / $219.46	Facility	TC	$59.58	$102.15	$219.46
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $73.29 / $124.99	Professional		$61.92	$73.29	$124.99
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $13.20 / $15.62 / $26.64	Professional	26	$13.20	$15.62	$26.64
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $48.72 / $57.67 / $98.35	Professional	TC	$48.72	$57.67	$98.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.47 / $109.53 / $321.02	Facility		$44.47	$109.53	$321.02
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 $202.72 / $279.23 / $423.47	Facility	TC	$202.72	$279.23	$423.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.70 / $103.34 / $199.28	Professional		$39.70	$103.34	$199.28
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $22.35 / $50.30	Professional	26	$11.40	$22.35	$50.30
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $173.99 / $173.99 / $173.99	Professional	50	$173.99	$173.99	$173.99
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $29.41 / $50.81 / $205.55	Professional	TC	$29.41	$50.81	$205.55
United Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $64.37 / $121.04	Professional		$37.72	$64.37	$121.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.74 / $16.80 / $29.70	Professional	26	$9.74	$16.80	$29.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.46 / $45.46 / $92.77	Professional	TC	$28.46	$45.46	$92.77