Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.81 / $27.81 / $27.81	Facility	26	$27.81	$27.81	$27.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $79.34 / $282.14	Professional		$49.69	$79.34	$282.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $28.24 / $150.44	Professional	26	$23.46	$28.24	$150.44
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.44 / $29.43 / $58.55	Professional	52	$23.44	$29.43	$58.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.09 / $43.58 / $69.59	Professional	TC	$25.09	$43.58	$69.59
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $22.75 / $22.75 / $22.75	Facility	26	$22.75	$22.75	$22.75
BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.37 / $150.07 / $200.60	Professional		$95.37	$150.07	$200.60
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $47.17 / $70.20 / $93.85	Professional	26	$47.17	$70.20	$93.85
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.34 / $87.28 / $106.75	Professional	TC	$57.34	$87.28	$106.75
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 $87.80 / $111.50 / $184.33	Professional		$87.80	$111.50	$184.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.56 / $50.92 / $84.17	Professional	26	$32.56	$50.92	$84.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.18 / $60.59 / $101.41	Professional	TC	$48.18	$60.59	$101.41
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 $87.80 / $87.80 / $170.42	Professional		$87.80	$87.80	$170.42
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 $47.71 / $47.71 / $89.77	Professional	TC	$47.71	$47.71	$89.77
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $122.62 / $122.62 / $122.62	Facility	26	$122.62	$122.62	$122.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $159.47 / $447.95	Professional		$80.48	$159.47	$447.95
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $53.96 / $265.83	Professional	26	$29.59	$53.96	$265.83
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $83.22 / $87.53 / $91.41	Professional	52	$83.22	$87.53	$91.41
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $101.78 / $398.99	Professional	TC	$50.89	$101.78	$398.99
United Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $151.27 / $257.02	Professional		$80.48	$151.27	$257.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.59 / $50.01 / $92.83	Professional	26	$29.59	$50.01	$92.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.26 / $93.72 / $169.43	Professional	TC	$47.26	$93.72	$169.43