Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $281.84 / $457.09	Facility		$97.72	$281.84	$457.09
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $7.94 / $13.80	Facility	26	$7.76	$7.94	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $181.97 / $281.84	Facility	TC	$26.30	$181.97	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.51 / $42.66 / $131.83	Professional		$8.51	$42.66	$131.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $16.60 / $47.86	Professional	26	$7.41	$16.60	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.62 / $79.43 / $204.17	Professional	50	$18.62	$79.43	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $3.80 / $3.80 / $3.80	Professional	52	$3.80	$3.80	$3.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $43.65 / $134.90	Professional	TC	$21.88	$43.65	$134.90
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 $5.89 / $6.76 / $6.76	Facility	26	$5.89	$6.76	$6.76
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $23.44 / $23.44	Facility	TC	$20.42	$23.44	$23.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $120.23	Professional		$56.23	$81.28	$120.23
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $19.05 / $28.84	Professional	26	$13.18	$19.05	$28.84
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $64.57 / $93.33	Professional	TC	$42.66	$64.57	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $128.82 / $309.03	Facility		$79.43	$128.82	$309.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $25.12 / $69.18	Facility	26	$6.61	$25.12	$69.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $87.10 / $239.88	Facility	TC	$20.42	$87.10	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $60.26 / $104.71	Professional		$32.36	$60.26	$104.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.79 / $24.55	Professional	26	$8.91	$14.79	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $47.86 / $81.28	Professional	TC	$23.44	$47.86	$81.28
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $123.03 / $245.47	Facility		$100.00	$123.03	$245.47
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $27.54 / $54.95	Facility	26	$22.39	$27.54	$54.95
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $77.62 / $95.50 / $190.55	Facility	TC	$77.62	$95.50	$190.55
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $51.29 / $83.18	Professional		$51.29	$51.29	$83.18
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $11.75 / $19.50	Professional	26	$11.75	$11.75	$19.50
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $39.81 / $63.10	Professional	TC	$39.81	$39.81	$63.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $158.49 / $309.03	Facility		$47.86	$158.49	$309.03
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 $181.97 / $269.15 / $371.54	Facility	TC	$181.97	$269.15	$371.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $97.72 / $186.21	Professional		$33.11	$97.72	$186.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $21.88 / $45.71	Professional	26	$11.75	$21.88	$45.71
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $57.54 / $57.54 / $83.18	Professional	52	$57.54	$57.54	$83.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $169.82	Professional	TC	$22.91	$41.69	$169.82
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 $31.62 / $50.12 / $102.33	Professional		$31.62	$50.12	$102.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $14.45 / $25.12	Professional	26	$8.51	$14.45	$25.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $37.15 / $79.43	Professional	TC	$22.91	$37.15	$79.43