Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.57 / $484.20 / $834.99	Facility		$117.57	$484.20	$834.99
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.47 / $27.47 / $41.20	Facility	26	$27.47	$27.47	$41.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.92 / $131.79 / $497.80	Professional		$96.92	$131.79	$497.80
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.23 / $34.60 / $124.36	Professional	26	$24.23	$34.60	$124.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $42.48 / $58.04 / $70.77	Professional	52	$42.48	$58.04	$70.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.84 / $90.10 / $234.07	Professional	TC	$71.84	$90.10	$234.07
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 $22.46 / $22.46 / $22.46	Facility	26	$22.46	$22.46	$22.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.00 / $290.49 / $388.30	Professional		$191.00	$290.49	$388.30
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.59 / $69.33 / $92.67	Professional	26	$46.59	$69.33	$92.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $153.96 / $234.31 / $295.62	Professional	TC	$153.96	$234.31	$295.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $256.38 / $400.14 / $962.58	Facility		$256.38	$400.14	$962.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.69 / $93.17 / $224.12	Facility	26	$59.69	$93.17	$224.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $213.98 / $350.78	Professional		$137.32	$213.98	$350.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.52 / $50.92 / $84.17	Professional	26	$33.52	$50.92	$84.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.39 / $163.06 / $267.31	Professional	TC	$103.39	$163.06	$267.31
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $222.17 / $365.15 / $757.94	Facility		$222.17	$365.15	$757.94
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $51.73 / $85.02 / $176.48	Facility	26	$51.73	$85.02	$176.48
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $168.49 / $168.49 / $327.05	Professional		$168.49	$168.49	$327.05
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $40.09 / $75.45	Professional	26	$40.09	$40.09	$75.45
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $128.40 / $128.40 / $249.23	Professional	TC	$128.40	$128.40	$249.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.75 / $329.36 / $555.40	Facility		$120.75	$329.36	$555.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $122.00 / $122.00 / $122.00	Facility	26	$122.00	$122.00	$122.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $294.58 / $559.66	Professional		$125.00	$294.58	$559.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.93 / $66.41 / $146.91	Professional	26	$33.93	$66.41	$146.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $89.14 / $168.85 / $554.94	Professional	TC	$89.14	$168.85	$554.94
United Facility/Professional Professional Modifier Low / Median / High Price $118.01 / $208.10 / $370.29	Professional		$118.01	$208.10	$370.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.87 / $51.50 / $88.10	Professional	26	$28.87	$51.50	$88.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.14 / $160.44 / $295.10	Professional	TC	$89.14	$160.44	$295.10