Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $602.56 / $1,096.48	Facility		$275.42	$602.56	$1,096.48
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $66.07	Facility	26	$38.90	$38.90	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $177.83 / $660.69	Professional		$100.00	$177.83	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $60.26 / $177.83	Professional	26	$34.67	$60.26	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $269.15	Professional	TC	$67.61	$100.00	$269.15
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 $28.18 / $32.36 / $32.36	Facility	26	$28.18	$32.36	$32.36
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $416.87	Professional		$190.55	$275.42	$416.87
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $138.04	Professional	26	$63.10	$91.20	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $194.98 / $275.42	Professional	TC	$125.89	$194.98	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $446.68 / $1,047.13	Facility		$251.19	$446.68	$1,047.13
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.90 / $120.23 / $331.13	Facility	26	$30.90	$120.23	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $218.78 / $354.81	Professional		$134.90	$218.78	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $70.79 / $112.20	Professional	26	$41.69	$70.79	$112.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $151.36 / $239.88	Professional	TC	$89.13	$151.36	$239.88
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $426.58 / $831.76	Facility		$338.84	$426.58	$831.76
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $134.90 / $263.03	Facility	26	$107.15	$134.90	$263.03
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $177.83 / $275.42	Professional		$177.83	$177.83	$275.42
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $56.23 / $89.13	Professional	26	$56.23	$56.23	$89.13
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $120.23 / $186.21	Professional	TC	$120.23	$120.23	$186.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $338.84 / $616.60	Facility		$138.04	$338.84	$616.60
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $173.78 / $173.78 / $173.78	Facility	26	$173.78	$173.78	$173.78
Medica Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $316.23 / $758.58	Professional		$125.89	$316.23	$758.58
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $95.50 / $208.93	Professional	26	$48.98	$95.50	$208.93
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $151.36 / $512.86	Professional	TC	$83.18	$151.36	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $223.87 / $363.08	Facility		$79.43	$223.87	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $208.93 / $363.08	Professional		$125.89	$208.93	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $69.18 / $120.23	Professional	26	$40.74	$69.18	$120.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $144.54 / $245.47	Professional	TC	$83.18	$144.54	$245.47