Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.64 / $166.73 / $394.34	Facility		$29.64	$166.73	$394.34
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.48 / $7.48 / $12.71	Facility	26	$7.48	$7.48	$12.71
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.17 / $22.17 / $37.68	Facility	TC	$22.17	$22.17	$37.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.10 / $29.64 / $106.61	Professional		$23.10	$29.64	$106.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.42 / $7.55 / $31.88	Professional	26	$6.42	$7.55	$31.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.55 / $40.00 / $75.81	Professional	50	$20.55	$40.00	$75.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $10.88 / $14.64 / $21.09	Professional	52	$10.88	$14.64	$21.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.82 / $20.64 / $42.20	Professional	TC	$16.82	$20.64	$42.20
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 $6.04 / $6.04 / $6.04	Facility	26	$6.04	$6.04	$6.04
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $18.14 / $18.14 / $18.14	Facility	TC	$18.14	$18.14	$18.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.50 / $83.18 / $100.89	Professional		$49.50	$83.18	$100.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.81 / $21.28 / $25.81	Professional	26	$12.81	$21.28	$25.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $39.95 / $61.90 / $75.08	Professional	TC	$39.95	$61.90	$75.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.32 / $100.49 / $247.11	Facility		$59.32	$100.49	$247.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.48 / $24.54 / $60.34	Facility	26	$14.48	$24.54	$60.34
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $44.83 / $75.95 / $186.77	Facility	TC	$44.83	$75.95	$186.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.10 / $54.78 / $90.68	Professional		$29.10	$54.78	$90.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.50 / $13.54 / $22.84	Professional	26	$8.50	$13.54	$22.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.01 / $41.25 / $69.05	Professional	TC	$21.01	$41.25	$69.05
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $52.82 / $90.57 / $194.58	Facility		$52.82	$90.57	$194.58
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $12.90 / $22.12 / $47.51	Facility	26	$12.90	$22.12	$47.51
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $39.92 / $68.45 / $147.06	Facility	TC	$39.92	$68.45	$147.06
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $51.06 / $87.08	Professional		$43.14	$51.06	$87.08
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $10.66 / $12.61 / $21.51	Professional	26	$10.66	$12.61	$21.51
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $32.47 / $38.44 / $65.56	Professional	TC	$32.47	$38.44	$65.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.28 / $51.02 / $148.66	Facility		$29.28	$51.02	$148.66
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 $100.00 / $175.16 / $234.64	Facility	TC	$100.00	$175.16	$234.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $50.22 / $180.63	Professional		$28.15	$50.22	$180.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.36 / $67.70	Professional	26	$7.94	$15.36	$67.70
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $43.97 / $47.80 / $113.40	Professional	52	$43.97	$47.80	$113.40
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $20.21 / $34.36 / $154.00	Professional	TC	$20.21	$34.36	$154.00
United Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $46.87 / $87.17	Professional		$28.15	$46.87	$87.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.66 / $24.59	Professional	26	$7.94	$13.66	$24.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.18 / $33.03 / $61.62	Professional	TC	$20.18	$33.03	$61.62