Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.70 / $65.70 / $111.03	Facility	26	$65.70	$65.70	$111.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.74 / $425.00 / $1,894.30	Professional		$147.74	$425.00	$1,894.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.42 / $140.00 / $390.60	Professional	26	$65.42	$140.00	$390.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $107.51 / $123.69 / $300.00	Professional	52	$107.51	$123.69	$300.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.66 / $335.00 / $1,331.90	Professional	TC	$155.66	$335.00	$1,331.90
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $53.84 / $53.84 / $53.84	Facility	26	$53.84	$53.84	$53.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $360.47 / $604.52 / $733.19	Professional		$360.47	$604.52	$733.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $111.22 / $184.74 / $224.06	Professional	26	$111.22	$184.74	$224.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $289.63 / $419.78 / $509.13	Professional	TC	$289.63	$419.78	$509.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $143.11 / $223.36 / $537.32	Facility	26	$143.11	$223.36	$537.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.19 / $424.97 / $993.02	Professional		$317.19	$424.97	$993.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.54 / $121.17 / $210.94	Professional	26	$72.54	$121.17	$210.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.78 / $299.70 / $812.79	Professional	TC	$221.78	$299.70	$812.79
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $124.02 / $196.93 / $423.09	Facility	26	$124.02	$196.93	$423.09
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $317.19 / $415.50 / $954.83	Professional		$317.19	$415.50	$954.83
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $95.41 / $121.68 / $192.61	Professional	26	$95.41	$121.68	$192.61
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $221.78 / $290.52 / $791.91	Professional	TC	$221.78	$290.52	$791.91
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $603.28 / $603.28 / $603.28	Facility	26	$603.28	$603.28	$603.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $264.81 / $581.20 / $2,791.06	Professional		$264.81	$581.20	$2,791.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $76.22 / $157.05 / $525.38	Professional	26	$76.22	$157.05	$525.38
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $860.72 / $860.72 / $4,581.92	Professional	50	$860.72	$860.72	$4,581.92
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $293.82 / $293.82 / $329.28	Professional	52	$293.82	$293.82	$329.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $179.44 / $340.06 / $2,451.15	Professional	TC	$179.44	$340.06	$2,451.15
United Facility/Professional Professional Modifier Low / Median / High Price $232.42 / $450.95 / $773.79	Professional		$232.42	$450.95	$773.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.36 / $115.64 / $211.45	Professional	26	$62.36	$115.64	$211.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $163.13 / $310.89 / $588.35	Professional	TC	$163.13	$310.89	$588.35