Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.08 / $377.22 / $539.65	Facility		$134.08	$377.22	$539.65
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.08 / $33.08 / $49.61	Facility	26	$33.08	$33.08	$49.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $92.83 / $417.00	Professional		$56.24	$92.83	$417.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.16 / $35.02 / $151.00	Professional	26	$29.16	$35.02	$151.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $102.89 / $528.51 / $672.00	Professional	50	$102.89	$528.51	$672.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.45 / $56.31 / $187.20	Professional	TC	$45.45	$56.31	$187.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.10 / $270.27 / $610.19	Facility		$118.10	$270.27	$610.19
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $223.79 / $299.14	Professional		$147.91	$223.79	$299.14
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.48 / $84.25 / $112.62	Professional	26	$56.48	$84.25	$112.62
BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $221.88 / $335.69 / $448.71	Professional	50	$221.88	$335.69	$448.71
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.14 / $147.84 / $186.52	Professional	TC	$97.14	$147.84	$186.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $195.92 / $305.77 / $735.58	Facility		$195.92	$305.77	$735.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.94 / $112.28 / $270.10	Facility	26	$71.94	$112.28	$270.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.36 / $164.35 / $269.42	Professional		$107.36	$164.35	$269.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.98 / $61.23 / $100.37	Professional	26	$41.98	$61.23	$100.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.34 / $103.12 / $168.84	Professional	TC	$65.34	$103.12	$168.84
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $169.78 / $279.04 / $579.20	Facility		$169.78	$279.04	$579.20
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $62.34 / $102.46 / $212.68	Facility	26	$62.34	$102.46	$212.68
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $129.41 / $129.41 / $251.20	Professional		$129.41	$129.41	$251.20
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $48.21 / $48.21 / $90.73	Professional	26	$48.21	$48.21	$90.73
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $81.20 / $81.20 / $157.62	Professional	TC	$81.20	$81.20	$157.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.12 / $275.44 / $498.99	Facility		$107.12	$275.44	$498.99
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $146.86 / $146.86 / $146.86	Facility	26	$146.86	$146.86	$146.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.05 / $213.53 / $437.06	Professional		$98.05	$213.53	$437.06
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $41.58 / $81.61 / $180.75	Professional	26	$41.58	$81.61	$180.75
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $289.02 / $412.15 / $629.15	Professional	50	$289.02	$412.15	$629.15
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $54.49 / $103.43 / $300.57	Professional	TC	$54.49	$103.43	$300.57
United Facility/Professional Professional Modifier Low / Median / High Price $89.14 / $161.86 / $271.77	Professional		$89.14	$161.86	$271.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.65 / $61.22 / $109.10	Professional	26	$34.65	$61.22	$109.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.49 / $105.46 / $181.41	Professional	TC	$54.49	$105.46	$181.41