Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $316.23 / $537.03	Facility		$128.82	$316.23	$537.03
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $9.12 / $15.85	Facility	26	$8.91	$9.12	$15.85
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $131.83 / $549.54	Facility	TC	$33.11	$131.83	$549.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $44.67 / $165.96	Professional		$9.33	$44.67	$165.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $18.20 / $52.48	Professional	26	$8.51	$18.20	$52.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.20 / $83.18 / $204.17	Professional	50	$18.20	$83.18	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $46.77 / $154.88	Professional	TC	$26.30	$46.77	$154.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $234.42 / $630.96	Facility		$138.04	$234.42	$630.96
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $7.94 / $7.94	Facility	26	$6.92	$7.94	$7.94
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $30.20 / $30.20	Facility	TC	$25.70	$30.20	$30.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $97.72 / $144.54	Professional		$67.61	$97.72	$144.54
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $21.38 / $32.36	Professional	26	$14.79	$21.38	$32.36
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $69.18 / $69.18 / $69.18	Professional	52	$69.18	$69.18	$69.18
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $79.43 / $114.82	Professional	TC	$52.48	$79.43	$114.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $151.36 / $371.54	Facility		$63.10	$151.36	$371.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.41 / $28.18 / $77.62	Facility	26	$7.41	$28.18	$77.62
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $24.55 / $104.71 / $288.40	Facility	TC	$24.55	$104.71	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $74.13 / $123.03	Professional		$37.15	$74.13	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $16.60 / $26.92	Professional	26	$10.00	$16.60	$26.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $60.26 / $97.72	Professional	TC	$28.18	$60.26	$97.72
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $288.40	Facility		$120.23	$147.91	$288.40
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $31.62 / $61.66	Facility	26	$25.12	$31.62	$61.66
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $93.33 / $114.82 / $229.09	Facility	TC	$93.33	$114.82	$229.09
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $61.66 / $102.33	Professional		$61.66	$61.66	$102.33
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $13.18 / $21.88	Professional	26	$13.18	$13.18	$21.88
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $48.98 / $81.28	Professional	TC	$48.98	$48.98	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $158.49 / $346.74	Facility		$53.70	$158.49	$346.74
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 $204.17 / $281.84 / $426.58	Facility	TC	$204.17	$281.84	$426.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $117.49 / $199.53	Professional		$39.81	$117.49	$199.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $23.44 / $51.29	Professional	26	$11.75	$23.44	$51.29
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $173.78 / $173.78	Professional	50	$173.78	$173.78	$173.78
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $50.12 / $204.17	Professional	TC	$28.18	$50.12	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $223.87 / $302.00	Facility		$218.78	$223.87	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $61.66 / $123.03	Professional		$38.02	$61.66	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $16.22 / $28.18	Professional	26	$9.33	$16.22	$28.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $45.71 / $97.72	Professional	TC	$28.18	$45.71	$97.72