Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $426.58 / $741.31	Facility		$208.93	$426.58	$741.31
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $33.11 / $56.23	Facility	26	$30.90	$33.11	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $398.11	Professional		$50.12	$100.00	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $66.07 / $181.97	Professional	26	$30.20	$66.07	$181.97
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $66.07 / $190.55 / $707.95	Professional	50	$66.07	$190.55	$707.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $58.88 / $186.21	Professional	TC	$43.65	$58.88	$186.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $309.03 / $660.69	Facility		$138.04	$309.03	$660.69
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $26.92 / $26.92	Facility	26	$23.44	$26.92	$26.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $199.53 / $302.00	Professional		$138.04	$199.53	$302.00
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $77.62 / $117.49	Professional	26	$53.70	$77.62	$117.49
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $208.93 / $302.00 / $436.52	Professional	50	$208.93	$302.00	$436.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $131.83 / $190.55	Professional	TC	$85.11	$131.83	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $323.59 / $776.25	Facility		$199.53	$323.59	$776.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.30 / $102.33 / $281.84	Facility	26	$26.30	$102.33	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $158.49 / $257.04	Professional		$93.33	$158.49	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $60.26 / $95.50	Professional	26	$37.15	$60.26	$95.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $100.00 / $162.18	Professional	TC	$58.88	$100.00	$162.18
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $309.03 / $602.56	Facility		$245.47	$309.03	$602.56
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $114.82 / $223.87	Facility	26	$91.20	$114.82	$223.87
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $204.17	Professional		$128.82	$128.82	$204.17
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $47.86 / $75.86	Professional	26	$47.86	$47.86	$75.86
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $81.28 / $128.82	Professional	TC	$81.28	$81.28	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $302.00 / $537.03	Facility		$120.23	$302.00	$537.03
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $147.91 / $147.91 / $147.91	Facility	26	$147.91	$147.91	$147.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $245.47 / $446.68	Professional		$89.13	$245.47	$446.68
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $87.10 / $181.97	Professional	26	$41.69	$87.10	$181.97
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $288.40 / $407.38 / $630.96	Professional	50	$288.40	$407.38	$630.96
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $100.00 / $338.84	Professional	TC	$51.29	$100.00	$338.84
United Facility/Professional Facility Modifier Low / Median / High Price $218.78 / $223.87 / $302.00	Facility		$218.78	$223.87	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $151.36 / $257.04	Professional		$87.10	$151.36	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $57.54 / $100.00	Professional	26	$34.67	$57.54	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $95.50 / $162.18	Professional	TC	$53.70	$95.50	$162.18