Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.15 / $33.15 / $33.15	Facility	26	$33.15	$33.15	$33.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $78.79 / $130.90	Professional		$61.50	$78.79	$130.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.24 / $33.15 / $48.65	Professional	26	$26.24	$33.15	$48.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $145.96 / $145.96 / $739.58	Professional	50	$145.96	$145.96	$739.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.49 / $45.64 / $67.19	Professional	TC	$34.49	$45.64	$67.19
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.35 / $27.35 / $27.35	Facility	26	$27.35	$27.35	$27.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.66 / $197.46 / $263.95	Professional		$126.66	$197.46	$263.95
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $55.90 / $83.37 / $111.44	Professional	26	$55.90	$83.37	$111.44
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.45 / $120.87 / $152.50	Professional	TC	$80.45	$120.87	$152.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.70 / $113.47 / $272.97	Facility	26	$72.70	$113.47	$272.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.50 / $145.02 / $239.73	Professional		$108.50	$145.02	$239.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $61.87 / $102.29	Professional	26	$40.72	$61.87	$102.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.79 / $83.14 / $137.44	Professional	TC	$64.79	$83.14	$137.44
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $63.00 / $103.55 / $214.94	Facility	26	$63.00	$103.55	$214.94
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $114.19 / $114.19 / $214.88	Professional		$114.19	$114.19	$214.88
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $48.72 / $91.68	Professional	26	$48.72	$48.72	$91.68
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $65.47 / $65.47 / $123.20	Professional	TC	$65.47	$65.47	$123.20
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $145.31 / $145.31 / $145.31	Facility	26	$145.31	$145.31	$145.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $101.41 / $180.92 / $583.91	Professional		$101.41	$180.92	$583.91
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $66.98 / $335.18	Professional	26	$36.81	$66.98	$335.18
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.59 / $114.65 / $353.01	Professional	TC	$64.59	$114.65	$353.01
United Facility/Professional Professional Modifier Low / Median / High Price $91.09 / $172.69 / $309.45	Professional		$91.09	$172.69	$309.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.81 / $65.67 / $120.47	Professional	26	$36.81	$65.67	$120.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.09 / $108.37 / $208.66	Professional	TC	$57.09	$108.37	$208.66