Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.26 / $264.41 / $461.45	Facility		$61.26	$264.41	$461.45
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.58 / $8.18 / $13.90	Facility	26	$7.58	$8.18	$13.90
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $27.86 / $183.46 / $308.30	Facility	TC	$27.86	$183.46	$308.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.56 / $40.50 / $153.00	Professional		$15.56	$40.50	$153.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $14.00 / $54.40	Professional	26	$7.33	$14.00	$54.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.60 / $15.60 / $113.29	Professional	50	$15.60	$15.60	$113.29
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $12.77 / $16.75 / $25.59	Professional	52	$12.77	$16.75	$25.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $33.54 / $145.96	Professional	TC	$21.32	$33.54	$145.96
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 $6.61 / $6.61 / $6.61	Facility	26	$6.61	$6.61	$6.61
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.75 / $22.75 / $22.75	Facility	TC	$22.75	$22.75	$22.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.40 / $99.62 / $120.83	Professional		$59.40	$99.62	$120.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.97 / $23.21 / $28.15	Professional	26	$13.97	$23.21	$28.15
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.26 / $76.41 / $92.67	Professional	TC	$48.26	$76.41	$92.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.04 / $120.35 / $295.95	Facility		$71.04	$120.35	$295.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.86 / $26.87 / $66.09	Facility	26	$15.86	$26.87	$66.09
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $55.18 / $93.48 / $229.87	Facility	TC	$55.18	$93.48	$229.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.08 / $65.73 / $108.82	Professional		$33.08	$65.73	$108.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $14.82 / $25.81	Professional	26	$9.19	$14.82	$25.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.67 / $50.92 / $84.28	Professional	TC	$24.67	$50.92	$84.28
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $63.26 / $108.47 / $233.04	Facility		$63.26	$108.47	$233.04
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $24.22 / $52.04	Facility	26	$14.13	$24.22	$52.04
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $49.14 / $84.25 / $181.00	Facility	TC	$49.14	$84.25	$181.00
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $51.77 / $61.27 / $104.50	Professional		$51.77	$61.27	$104.50
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $11.67 / $13.82 / $23.56	Professional	26	$11.67	$13.82	$23.56
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $40.09 / $47.46 / $80.94	Professional	TC	$40.09	$47.46	$80.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.66 / $131.60 / $297.00	Facility		$41.66	$131.60	$297.00
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 $176.10 / $257.79 / $372.51	Facility	TC	$176.10	$257.79	$372.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.20 / $91.67 / $189.88	Professional		$33.20	$91.67	$189.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.39 / $20.57 / $44.88	Professional	26	$10.39	$20.57	$44.88
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $57.43 / $57.43 / $83.25	Professional	52	$57.43	$57.43	$83.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.26 / $41.43 / $170.86	Professional	TC	$24.26	$41.43	$170.86
United Facility/Professional Professional Modifier Low / Median / High Price $32.01 / $54.24 / $101.22	Professional		$32.01	$54.24	$101.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $14.72 / $26.40	Professional	26	$8.66	$14.72	$26.40
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.00 / $37.14 / $74.81	Professional	TC	$23.00	$37.14	$74.81