Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.35 / $11.35 / $17.02	Facility	26	$11.35	$11.35	$17.02
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.81 / $247.91 / $352.17	Facility	TC	$37.81	$247.91	$352.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.75 / $55.18 / $240.30	Professional		$26.75	$55.18	$240.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.02 / $21.20 / $62.40	Professional	26	$10.02	$21.20	$62.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $87.18 / $296.00 / $414.00	Professional	50	$87.18	$296.00	$414.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $17.14 / $22.76 / $34.89	Professional	52	$17.14	$22.76	$34.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.87 / $37.81 / $203.92	Professional	TC	$27.87	$37.81	$203.92
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.21 / $9.21 / $9.21	Facility	26	$9.21	$9.21	$9.21
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $31.96 / $31.96 / $31.96	Facility	TC	$31.96	$31.96	$31.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.69 / $137.35 / $166.58	Professional		$82.69	$137.35	$166.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $31.92 / $38.71	Professional	26	$19.22	$31.92	$38.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.20 / $105.43 / $127.87	Professional	TC	$67.20	$105.43	$127.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.07 / $37.39 / $91.95	Facility	26	$22.07	$37.39	$91.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $76.56 / $129.69 / $318.94	Facility	TC	$76.56	$129.69	$318.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.32 / $92.17 / $152.56	Professional		$44.32	$92.17	$152.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.32 / $20.62 / $34.81	Professional	26	$12.32	$20.62	$34.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.11 / $71.54 / $118.42	Professional	TC	$32.11	$71.54	$118.42
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $19.64 / $33.70 / $72.40	Facility	26	$19.64	$33.70	$72.40
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $68.18 / $116.89 / $251.14	Facility	TC	$68.18	$116.89	$251.14
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $85.90 / $146.50	Professional		$72.56	$85.90	$146.50
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $16.23 / $19.22 / $32.78	Professional	26	$16.23	$19.22	$32.78
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $56.33 / $66.68 / $113.72	Professional	TC	$56.33	$66.68	$113.72
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 $288.95 / $351.66 / $456.50	Facility	TC	$288.95	$351.66	$456.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $88.78 / $297.63	Professional		$44.39	$88.78	$297.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.71 / $26.58 / $87.52	Professional	26	$12.71	$26.58	$87.52
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $19.48 / $28.62 / $70.00	Professional	50	$19.48	$28.62	$70.00
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $79.50 / $79.50 / $79.50	Professional	52	$79.50	$79.50	$79.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.79 / $55.52 / $229.42	Professional	TC	$32.79	$55.52	$229.42
United Facility/Professional Professional Modifier Low / Median / High Price $42.24 / $71.45 / $142.06	Professional		$42.24	$71.45	$142.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.55 / $20.07 / $35.76	Professional	26	$11.55	$20.07	$35.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.41 / $52.07 / $101.69	Professional	TC	$31.41	$52.07	$101.69