Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.27 / $127.30 / $421.89	Facility		$34.27	$127.30	$421.89
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.19 / $8.19 / $13.92	Facility	26	$8.19	$8.19	$13.92
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.08 / $26.08 / $39.11	Facility	TC	$26.08	$26.08	$39.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $31.75 / $97.20	Professional		$19.80	$31.75	$97.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $8.19 / $29.70	Professional	26	$7.00	$8.19	$29.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $86.52 / $96.08 / $96.08	Professional	50	$86.52	$96.08	$96.08
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.90 / $15.96 / $24.33	Professional	52	$11.90	$15.96	$24.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $24.08 / $72.09	Professional	TC	$18.53	$24.08	$72.09
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 $6.33 / $6.33 / $6.33	Facility	26	$6.33	$6.33	$6.33
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $21.30 / $21.30 / $21.30	Facility	TC	$21.30	$21.30	$21.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.90 / $93.82 / $113.79	Professional		$55.90	$93.82	$113.79
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $22.25 / $26.98	Professional	26	$13.40	$22.25	$26.98
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.21 / $71.56 / $86.81	Professional	TC	$45.21	$71.56	$86.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.90 / $113.34 / $278.72	Facility		$66.90	$113.34	$278.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.17 / $25.71 / $63.21	Facility	26	$15.17	$25.71	$63.21
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $51.73 / $87.63 / $215.50	Facility	TC	$51.73	$87.63	$215.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.77 / $61.87 / $102.42	Professional		$31.77	$61.87	$102.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.86 / $14.18 / $23.93	Professional	26	$8.86	$14.18	$23.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.60 / $47.69 / $78.95	Professional	TC	$22.60	$47.69	$78.95
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $59.58 / $102.15 / $219.46	Facility		$59.58	$102.15	$219.46
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $13.51 / $23.17 / $49.78	Facility	26	$13.51	$23.17	$49.78
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $46.07 / $78.98 / $169.69	Facility	TC	$46.07	$78.98	$169.69
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $48.72 / $57.67 / $98.35	Professional		$48.72	$57.67	$98.35
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $13.22 / $22.54	Professional	26	$11.17	$13.22	$22.54
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $37.56 / $44.45 / $75.81	Professional	TC	$37.56	$44.45	$75.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.76 / $57.78 / $179.35	Facility		$31.76	$57.78	$179.35
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 $110.20 / $179.14 / $290.82	Facility	TC	$110.20	$179.14	$290.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $57.82 / $206.66	Professional		$32.11	$57.82	$206.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $16.54 / $67.70	Professional	26	$8.66	$16.54	$67.70
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $47.52 / $54.04 / $99.75	Professional	52	$47.52	$54.04	$99.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.46 / $40.11 / $157.81	Professional	TC	$23.46	$40.11	$157.81
United Facility/Professional Professional Modifier Low / Median / High Price $31.68 / $53.79 / $99.46	Professional		$31.68	$53.79	$99.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.23 / $13.77 / $26.40	Professional	26	$8.23	$13.77	$26.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.28 / $42.30 / $77.64	Professional	TC	$22.28	$42.30	$77.64