Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.09 / $13.09 / $13.09	Facility	26	$13.09	$13.09	$13.09
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.11 / $32.11 / $32.11	Facility	TC	$32.11	$32.11	$32.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.18 / $41.85 / $74.94	Professional		$35.18	$41.85	$74.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.84 / $13.09 / $20.86	Professional	26	$10.84	$13.09	$20.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.17 / $27.96 / $45.07	Professional	TC	$23.17	$27.96	$45.07
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.65 / $10.65 / $10.65	Facility	26	$10.65	$10.65	$10.65
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $26.20 / $26.20 / $26.20	Facility	TC	$26.20	$26.20	$26.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.54 / $124.77 / $151.33	Professional		$74.54	$124.77	$151.33
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.13 / $36.76 / $44.58	Professional	26	$22.13	$36.76	$44.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $88.02 / $106.75	Professional	TC	$61.66	$88.02	$106.75
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.52 / $43.23 / $106.31	Facility	26	$25.52	$43.23	$106.31
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $63.46 / $107.50 / $264.35	Facility	TC	$63.46	$107.50	$264.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.61 / $82.50 / $138.09	Professional		$43.61	$82.50	$138.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.22 / $23.85 / $39.92	Professional	26	$15.22	$23.85	$39.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.78 / $58.65 / $97.08	Professional	TC	$28.78	$58.65	$97.08
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $22.73 / $38.96 / $83.71	Facility	26	$22.73	$38.96	$83.71
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $56.51 / $96.89 / $208.15	Facility	TC	$56.51	$96.89	$208.15
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $64.95 / $76.89 / $131.13	Professional		$64.95	$76.89	$131.13
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $18.78 / $22.23 / $37.90	Professional	26	$18.78	$22.23	$37.90
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $46.18 / $54.66 / $93.23	Professional	TC	$46.18	$54.66	$93.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $72.58 / $269.77	Professional		$42.22	$72.58	$269.77
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $24.44 / $68.66	Professional	26	$13.71	$24.44	$68.66
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.21 / $47.54 / $196.89	Professional	TC	$28.21	$47.54	$196.89
United Facility/Professional Professional Modifier Low / Median / High Price $42.22 / $69.68 / $128.72	Professional		$42.22	$69.68	$128.72
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.71 / $21.80 / $41.80	Professional	26	$13.71	$21.80	$41.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.21 / $47.54 / $86.92	Professional	TC	$28.21	$47.54	$86.92