Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $537.03 / $831.76	Facility		$208.93	$537.03	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $26.92 / $46.77	Facility	26	$25.70	$26.92	$46.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $162.18 / $602.56	Professional		$95.50	$162.18	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $43.65 / $131.83	Professional	26	$23.99	$43.65	$131.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $102.33 / $239.88	Professional	52	$28.18	$102.33	$239.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $93.33 / $251.19	Professional	TC	$70.79	$93.33	$251.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $331.13 / $794.33	Facility		$165.96	$331.13	$794.33
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $19.95 / $22.91 / $22.91	Facility	26	$19.95	$22.91	$22.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $263.03 / $398.11	Professional		$177.83	$263.03	$398.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $64.57 / $95.50	Professional	26	$43.65	$64.57	$95.50
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $208.93 / $295.12	Professional	TC	$134.90	$208.93	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $426.58 / $1,000.00	Facility		$263.03	$426.58	$1,000.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $85.11 / $234.42	Facility	26	$21.88	$85.11	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $208.93 / $331.13	Professional		$112.20	$208.93	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $50.12 / $79.43	Professional	26	$29.51	$50.12	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $162.18 / $257.04	Professional	TC	$85.11	$162.18	$257.04
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $407.38 / $794.33	Facility		$323.59	$407.38	$794.33
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $95.50 / $186.21	Facility	26	$75.86	$95.50	$186.21
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $263.03	Professional		$169.82	$169.82	$263.03
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $39.81 / $63.10	Professional	26	$39.81	$39.81	$63.10
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $128.82 / $204.17	Professional	TC	$128.82	$128.82	$204.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $380.19 / $602.56	Facility		$125.89	$380.19	$602.56
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $123.03 / $123.03 / $123.03	Facility	26	$123.03	$123.03	$123.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $309.03 / $616.60	Professional		$117.49	$309.03	$616.60
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $70.79 / $147.91	Professional	26	$33.88	$70.79	$147.91
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $165.96 / $549.54	Professional	TC	$81.28	$165.96	$549.54
United Facility/Professional Facility Modifier Low / Median / High Price $263.03 / $269.15 / $363.08	Facility		$263.03	$269.15	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $190.55 / $338.84	Professional		$112.20	$190.55	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.86 / $83.18	Professional	26	$28.18	$47.86	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $144.54 / $257.04	Professional	TC	$87.10	$144.54	$257.04