Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.25 / $43.25 / $43.25	Facility	26	$43.25	$43.25	$43.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.14 / $136.49 / $539.60	Professional		$109.14	$136.49	$539.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.91 / $43.25 / $117.00	Professional	26	$29.91	$43.25	$117.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.23 / $94.37 / $148.36	Professional	TC	$79.23	$94.37	$148.36
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $35.40 / $35.40 / $35.40	Facility	26	$35.40	$35.40	$35.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.18 / $403.33 / $489.18	Professional		$238.18	$403.33	$489.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $121.87 / $147.81	Professional	26	$73.37	$121.87	$147.81
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $192.76 / $281.45 / $341.37	Professional	TC	$192.76	$281.45	$341.37
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.53 / $144.88 / $356.30	Facility	26	$85.53	$144.88	$356.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $266.19 / $440.61	Professional		$131.44	$266.19	$440.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.57 / $79.92 / $133.78	Professional	26	$38.57	$79.92	$133.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.37 / $186.27 / $311.79	Professional	TC	$92.37	$186.27	$311.79
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $76.16 / $130.58 / $280.55	Facility	26	$76.16	$130.58	$280.55
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $209.60 / $248.09 / $423.12	Professional		$209.60	$248.09	$423.12
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $62.93 / $74.48 / $127.04	Professional	26	$62.93	$74.48	$127.04
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $146.66 / $173.60 / $296.08	Professional	TC	$146.66	$173.60	$296.08
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $190.76 / $190.76 / $190.76	Facility	26	$190.76	$190.76	$190.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $140.44 / $239.73 / $927.52	Professional		$140.44	$239.73	$927.52
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.88 / $74.67 / $268.38	Professional	26	$43.88	$74.67	$268.38
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $170.21 / $659.08	Professional	TC	$94.56	$170.21	$659.08
United Facility/Professional Professional Modifier Low / Median / High Price $133.97 / $251.41 / $439.18	Professional		$133.97	$251.41	$439.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.45 / $65.50 / $140.82	Professional	26	$42.45	$65.50	$140.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $94.56 / $167.32 / $288.29	Professional	TC	$94.56	$167.32	$288.29