Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $12.88 / $12.88	Facility	26	$12.88	$12.88	$12.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	TC	$32.36	$32.36	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $44.67 / $123.03	Professional		$33.88	$44.67	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $15.49 / $40.74	Professional	26	$10.47	$15.49	$40.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.84 / $63.10	Professional	TC	$21.88	$28.84	$63.10
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $10.72 / $10.72	Facility	26	$9.33	$10.72	$10.72
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $22.91 / $26.92 / $26.92	Facility	TC	$22.91	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $102.33 / $151.36	Professional		$70.79	$102.33	$151.36
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $30.90 / $45.71	Professional	26	$21.88	$30.90	$45.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $75.86 / $107.15	Professional	TC	$51.29	$75.86	$107.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.47 / $40.74 / $112.20	Facility	26	$10.47	$40.74	$112.20
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $100.00 / $275.42	Facility	TC	$23.44	$100.00	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $79.43 / $131.83	Professional		$42.66	$79.43	$131.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $23.99 / $38.02	Professional	26	$14.79	$23.99	$38.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $54.95 / $93.33	Professional	TC	$28.18	$54.95	$93.33
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $35.48 / $44.67 / $87.10	Facility	26	$35.48	$44.67	$87.10
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $89.13 / $109.65 / $218.78	Facility	TC	$89.13	$109.65	$218.78
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $64.57 / $102.33	Professional		$64.57	$64.57	$102.33
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $18.62 / $29.51	Professional	26	$18.62	$18.62	$29.51
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $45.71 / $72.44	Professional	TC	$45.71	$45.71	$72.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $275.42	Professional		$39.81	$66.07	$275.42
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $23.99 / $81.28	Professional	26	$13.80	$23.99	$81.28
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $43.65 / $194.98	Professional	TC	$25.70	$43.65	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $66.07 / $128.82	Professional		$39.81	$66.07	$128.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $22.91 / $39.81	Professional	26	$13.49	$22.91	$39.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $91.20	Professional	TC	$26.92	$43.65	$91.20