Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.33 / $111.33 / $476.30	Facility		$111.33	$111.33	$476.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.90 / $15.90 / $27.03	Facility	26	$15.90	$15.90	$27.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.59 / $98.51 / $159.26	Professional		$81.59	$98.51	$159.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.16 / $15.90 / $56.96	Professional	26	$13.16	$15.90	$56.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.40 / $82.10 / $132.75	Professional	TC	$67.40	$82.10	$132.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $318.45 / $710.84 / $1,544.64	Facility		$318.45	$710.84	$1,544.64
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $12.95 / $12.95 / $12.95	Facility	26	$12.95	$12.95	$12.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.03 / $301.77 / $366.01	Professional		$177.03	$301.77	$366.01
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.78 / $44.49 / $53.96	Professional	26	$26.78	$44.49	$53.96
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $168.05 / $257.27 / $312.04	Professional	TC	$168.05	$257.27	$312.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $218.64 / $370.40 / $910.86	Facility		$218.64	$370.40	$910.86
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.04 / $52.58 / $129.30	Facility	26	$31.04	$52.58	$129.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $92.87 / $198.51 / $328.59	Professional		$92.87	$198.51	$328.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.59 / $29.00 / $48.95	Professional	26	$17.59	$29.00	$48.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.20 / $169.51 / $280.22	Professional	TC	$78.20	$169.51	$280.22
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $194.70 / $333.83 / $717.21	Facility		$194.70	$333.83	$717.21
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $27.64 / $47.39 / $101.81	Facility	26	$27.64	$47.39	$101.81
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $156.31 / $185.02 / $315.55	Professional		$156.31	$185.02	$315.55
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $27.03 / $46.10	Professional	26	$22.84	$27.03	$46.10
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $133.47 / $157.97 / $269.44	Professional	TC	$133.47	$157.97	$269.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $93.41 / $176.44 / $327.51	Facility		$93.41	$176.44	$327.51
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 Professional Modifier Low / Median / High Price $93.95 / $161.66 / $687.89	Professional		$93.95	$161.66	$687.89
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $30.29 / $150.00	Professional	26	$16.60	$30.29	$150.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $78.18 / $130.84 / $591.79	Professional	TC	$78.18	$130.84	$591.79
United Facility/Professional Professional Modifier Low / Median / High Price $93.42 / $148.19 / $306.20	Professional		$93.42	$148.19	$306.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $29.24 / $50.61	Professional	26	$16.60	$29.24	$50.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.18 / $123.97 / $254.81	Professional	TC	$78.18	$123.97	$254.81