Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $10.96 / $19.50	Facility	26	$10.96	$10.96	$19.50
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $37.15 / $346.74 / $707.95	Facility	TC	$37.15	$346.74	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $56.23 / $204.17	Professional		$20.42	$56.23	$204.17
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $22.91 / $61.66	Professional	26	$10.23	$22.91	$61.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.31 / $114.82 / $263.03	Professional	50	$36.31	$114.82	$263.03
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.65 / $43.65 / $43.65	Professional	52	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $54.95 / $186.21	Professional	TC	$28.18	$54.95	$186.21
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $8.32 / $9.55 / $9.55	Facility	26	$8.32	$9.55	$9.55
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $34.67 / $34.67	Facility	TC	$30.20	$34.67	$34.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $112.20 / $169.82	Professional		$77.62	$112.20	$169.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $26.30 / $38.90	Professional	26	$18.20	$26.30	$38.90
BCBS Facility/Professional Professional Modifier 52 Low / Median / High Price $81.28 / $81.28 / $81.28	Professional	52	$81.28	$81.28	$81.28
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $91.20 / $131.83	Professional	TC	$60.26	$91.20	$131.83
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $34.67 / $95.50	Facility	26	$8.91	$34.67	$95.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $120.23 / $331.13	Facility	TC	$28.18	$120.23	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $83.18 / $144.54	Professional		$42.66	$83.18	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $20.42 / $33.11	Professional	26	$12.02	$20.42	$33.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $64.57 / $114.82	Professional	TC	$30.90	$64.57	$114.82
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $38.90 / $75.86	Facility	26	$30.90	$38.90	$75.86
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $107.15 / $134.90 / $263.03	Facility	TC	$107.15	$134.90	$263.03
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $72.44 / $112.20	Professional		$72.44	$72.44	$112.20
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $25.12	Professional	26	$16.22	$16.22	$25.12
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $56.23 / $87.10	Professional	TC	$56.23	$56.23	$87.10
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 $288.40 / $354.81 / $457.09	Facility	TC	$288.40	$354.81	$457.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $128.82 / $295.12	Professional		$43.65	$128.82	$295.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $30.20 / $87.10	Professional	26	$13.49	$30.20	$87.10
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $19.50 / $28.84 / $70.79	Professional	50	$19.50	$28.84	$70.79
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $79.43 / $79.43 / $79.43	Professional	52	$79.43	$79.43	$79.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $54.95 / $229.09	Professional	TC	$30.90	$54.95	$229.09
United Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $67.61 / $144.54	Professional		$42.66	$67.61	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $19.05 / $33.88	Professional	26	$11.22	$19.05	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.12 / $109.65	Professional	TC	$30.90	$50.12	$109.65