Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $281.84 / $524.81	Facility		$147.91	$281.84	$524.81
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $7.94 / $14.45	Facility	26	$7.94	$7.94	$14.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $263.03 / $281.84	Facility	TC	$30.20	$263.03	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.77 / $40.74 / $131.83	Professional		$9.77	$40.74	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $16.60 / $46.77	Professional	26	$7.76	$16.60	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.50 / $95.50 / $204.17	Professional	50	$19.50	$95.50	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $42.66 / $107.15	Professional	TC	$22.91	$42.66	$107.15
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 $6.17 / $7.08 / $7.08	Facility	26	$6.17	$7.08	$7.08
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.39 / $25.70 / $25.70	Facility	TC	$22.39	$25.70	$25.70
BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $87.10 / $128.82	Professional		$60.26	$87.10	$128.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $19.95 / $29.51	Professional	26	$13.80	$19.95	$29.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $69.18 / $100.00	Professional	TC	$45.71	$69.18	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $134.90 / $331.13	Facility		$57.54	$134.90	$331.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.76 / $26.30 / $72.44	Facility	26	$6.76	$26.30	$72.44
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $21.88 / $93.33 / $257.04	Facility	TC	$21.88	$93.33	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.57 / $109.65	Professional		$33.88	$64.57	$109.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $15.49 / $25.12	Professional	26	$9.12	$15.49	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $51.29 / $87.10	Professional	TC	$25.12	$51.29	$87.10
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $131.83 / $263.03	Facility		$107.15	$131.83	$263.03
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $28.84 / $56.23	Facility	26	$23.44	$28.84	$56.23
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $83.18 / $102.33 / $204.17	Facility	TC	$83.18	$102.33	$204.17
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $54.95 / $87.10	Professional		$54.95	$54.95	$87.10
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $19.05	Professional	26	$12.30	$12.30	$19.05
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $42.66 / $67.61	Professional	TC	$42.66	$42.66	$67.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $165.96 / $331.13	Facility		$48.98	$165.96	$331.13
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 $177.83 / $257.04 / $354.81	Facility	TC	$177.83	$257.04	$354.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $102.33 / $186.21	Professional		$35.48	$102.33	$186.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $22.91 / $46.77	Professional	26	$12.02	$22.91	$46.77
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $87.10 / $87.10 / $87.10	Professional	52	$87.10	$87.10	$87.10
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $44.67 / $181.97	Professional	TC	$25.12	$44.67	$181.97
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 $33.88 / $53.70 / $109.65	Professional		$33.88	$53.70	$109.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.79 / $25.70	Professional	26	$8.51	$14.79	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $85.11	Professional	TC	$25.12	$40.74	$85.11