Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.01 / $50.01 / $349.05	Facility		$50.01	$50.01	$349.05
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.40 / $31.40 / $31.40	Facility	26	$31.40	$31.40	$31.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $82.23 / $173.71	Professional		$42.30	$82.23	$173.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.57 / $38.34 / $106.04	Professional	26	$25.57	$38.34	$106.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $94.51 / $179.00	Professional	50	$82.23	$94.51	$179.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.16 / $21.47 / $45.23	Professional	TC	$14.16	$21.47	$45.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.90 / $299.39 / $648.22	Facility		$142.90	$299.39	$648.22
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.62 / $25.62 / $25.62	Facility	26	$25.62	$25.62	$25.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.27 / $126.37 / $168.93	Professional		$83.27	$126.37	$168.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.41 / $79.50 / $105.58	Professional	26	$52.41	$79.50	$105.58
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $32.99 / $50.21 / $63.35	Professional	TC	$32.99	$50.21	$63.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.20 / $172.00 / $413.77	Facility		$110.20	$172.00	$413.77
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.88 / $107.50 / $258.60	Facility	26	$68.88	$107.50	$258.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.30 / $92.17 / $154.28	Professional		$73.30	$92.17	$154.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $58.01 / $95.89	Professional	26	$45.68	$58.01	$95.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.17 / $34.15 / $64.28	Professional	TC	$27.17	$34.15	$64.28
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $156.96 / $325.80	Facility		$95.50	$156.96	$325.80
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $59.69 / $94.78 / $203.63	Facility	26	$59.69	$94.78	$203.63
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $72.56 / $72.56 / $136.57	Professional		$72.56	$72.56	$136.57
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $45.68 / $85.95	Professional	26	$45.68	$45.68	$85.95
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $26.90 / $26.90 / $50.62	Professional	TC	$26.90	$26.90	$50.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.46 / $105.99 / $208.32	Facility		$53.46	$105.99	$208.32
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $198.78 / $198.78 / $198.78	Facility	26	$198.78	$198.78	$198.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.14 / $138.53 / $659.45	Professional		$60.14	$138.53	$659.45
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.60 / $79.41 / $335.18	Professional	26	$36.60	$79.41	$335.18
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $891.41 / $891.41 / $891.41	Professional	50	$891.41	$891.41	$891.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $56.92 / $404.98	Professional	TC	$23.82	$56.92	$404.98
United Facility/Professional Professional Modifier Low / Median / High Price $57.52 / $131.18 / $187.40	Professional		$57.52	$131.18	$187.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.11 / $70.08 / $107.34	Professional	26	$32.11	$70.08	$107.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.65 / $52.78 / $77.45	Professional	TC	$21.65	$52.78	$77.45