Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.05 / $31.05 / $31.05	Facility	26	$31.05	$31.05	$31.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.18 / $70.65 / $119.80	Professional		$55.18	$70.65	$119.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.73 / $30.45 / $45.49	Professional	26	$24.73	$30.45	$45.49
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.32 / $35.21 / $46.90	Professional	52	$25.32	$35.21	$46.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.94 / $39.59 / $60.00	Professional	TC	$29.94	$39.59	$60.00
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 $117.51 / $179.03 / $239.31	Professional		$117.51	$179.03	$239.31
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.41 / $78.11 / $104.41	Professional	26	$52.41	$78.11	$104.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.38 / $107.93 / $134.91	Professional	TC	$71.38	$107.93	$134.91
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.11 / $106.30 / $255.73	Facility	26	$68.11	$106.30	$255.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.74 / $132.77 / $217.65	Professional		$93.74	$132.77	$217.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.69 / $58.01 / $95.89	Professional	26	$36.69	$58.01	$95.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.38 / $74.76 / $123.60	Professional	TC	$54.38	$74.76	$123.60
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $59.02 / $97.01 / $201.36	Facility	26	$59.02	$97.01	$201.36
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $104.55 / $196.73	Professional		$104.55	$104.55	$196.73
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 $58.87 / $58.87 / $110.78	Professional	TC	$58.87	$58.87	$110.78
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $136.22 / $136.22 / $136.22	Facility	26	$136.22	$136.22	$136.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.64 / $138.16 / $497.00	Professional		$74.64	$138.16	$497.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $58.33 / $320.31	Professional	26	$31.76	$58.33	$320.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $42.35 / $84.39 / $320.31	Professional	TC	$42.35	$84.39	$320.31
United Facility/Professional Professional Modifier Low / Median / High Price $69.95 / $133.84 / $223.18	Professional		$69.95	$133.84	$223.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $56.66 / $103.88	Professional	26	$31.76	$56.66	$103.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.09 / $75.14 / $120.15	Professional	TC	$36.09	$75.14	$120.15