Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.12 / $271.61 / $539.44	Facility		$114.12	$271.61	$539.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.53 / $8.53 / $14.51	Facility	26	$8.53	$8.53	$14.51
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.35 / $251.18 / $284.95	Facility	TC	$30.35	$251.18	$284.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.98 / $39.40 / $177.11	Professional		$12.98	$39.40	$177.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $12.52 / $49.78	Professional	26	$7.33	$12.52	$49.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $39.78 / $39.78 / $112.99	Professional	50	$39.78	$39.78	$112.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.64 / $18.04 / $27.59	Professional	52	$13.64	$18.04	$27.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.94 / $30.35 / $130.00	Professional	TC	$21.94	$30.35	$130.00
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 $6.90 / $6.90 / $6.90	Facility	26	$6.90	$6.90	$6.90
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $24.47 / $24.47 / $24.47	Facility	TC	$24.47	$24.47	$24.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.48 / $106.39 / $129.04	Professional		$63.48	$106.39	$129.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $24.18 / $29.33	Professional	26	$14.56	$24.18	$29.33
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.74 / $82.21 / $99.71	Professional	TC	$54.74	$82.21	$99.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.87 / $128.53 / $316.07	Facility		$75.87	$128.53	$316.07
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $16.55 / $28.04 / $68.95	Facility	26	$16.55	$28.04	$68.95
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $59.32 / $100.49 / $247.11	Facility	TC	$59.32	$100.49	$247.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $70.25 / $116.29	Professional		$35.36	$70.25	$116.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.27 / $15.47 / $26.11	Professional	26	$9.27	$15.47	$26.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.28 / $54.78 / $90.68	Professional	TC	$25.28	$54.78	$90.68
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $67.56 / $115.84 / $248.88	Facility		$67.56	$115.84	$248.88
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $14.74 / $25.27 / $54.30	Facility	26	$14.74	$25.27	$54.30
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $52.82 / $90.57 / $194.58	Facility	TC	$52.82	$90.57	$194.58
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $55.32 / $65.48 / $111.67	Professional		$55.32	$65.48	$111.67
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $12.18 / $14.42 / $24.59	Professional	26	$12.18	$14.42	$24.59
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $43.14 / $51.06 / $87.08	Professional	TC	$43.14	$51.06	$87.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $129.79 / $300.35	Facility		$42.11	$129.79	$300.35
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 $178.68 / $259.89 / $347.60	Facility	TC	$178.68	$259.89	$347.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $86.66 / $194.58	Professional		$35.36	$86.66	$194.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.82 / $21.60 / $46.46	Professional	26	$10.82	$21.60	$46.46
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $87.75 / $87.75 / $87.75	Professional	52	$87.75	$87.75	$87.75
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $45.03 / $183.85	Professional	TC	$26.35	$45.03	$183.85
United Facility/Professional Professional Modifier Low / Median / High Price $33.60 / $56.61 / $107.84	Professional		$33.60	$56.61	$107.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.02 / $15.44 / $27.50	Professional	26	$9.02	$15.44	$27.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.03 / $41.56 / $80.34	Professional	TC	$25.03	$41.56	$80.34