Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.09 / $468.35 / $1,127.98	Facility		$123.09	$468.35	$1,127.98
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.04 / $39.04 / $65.97	Facility	26	$39.04	$39.04	$65.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.22 / $146.41 / $612.00	Professional		$102.22	$146.41	$612.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.40 / $45.33 / $189.05	Professional	26	$34.40	$45.33	$189.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.01 / $87.95 / $223.39	Professional	TC	$67.01	$87.95	$223.39
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.90 / $299.39 / $648.22	Facility		$142.90	$299.39	$648.22
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $31.96 / $31.96 / $31.96	Facility	26	$31.96	$31.96	$31.96
BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.48 / $306.27 / $409.41	Professional		$201.48	$306.27	$409.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.39 / $99.17 / $132.56	Professional	26	$66.39	$99.17	$132.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.18 / $219.43 / $276.85	Professional	TC	$144.18	$219.43	$276.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $269.39 / $420.44 / $1,011.43	Facility		$269.39	$420.44	$1,011.43
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.95 / $132.58 / $318.94	Facility	26	$84.95	$132.58	$318.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.93 / $224.29 / $370.79	Professional		$152.93	$224.29	$370.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.18 / $72.19 / $119.33	Professional	26	$48.18	$72.19	$119.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.29 / $152.11 / $251.45	Professional	TC	$105.29	$152.11	$251.45
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $233.45 / $383.68 / $796.40	Facility		$233.45	$383.68	$796.40
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $73.62 / $120.99 / $251.14	Facility	26	$73.62	$120.99	$251.14
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $176.61 / $176.61 / $332.34	Professional		$176.61	$176.61	$332.34
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $56.84 / $106.96	Professional	26	$56.84	$56.84	$106.96
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $119.77 / $119.77 / $225.38	Professional	TC	$119.77	$119.77	$225.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.65 / $285.82 / $577.92	Facility		$139.65	$285.82	$577.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $172.60 / $172.60 / $172.60	Facility	26	$172.60	$172.60	$172.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.75 / $292.39 / $659.88	Professional		$137.75	$292.39	$659.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.30 / $89.65 / $210.51	Professional	26	$49.30	$89.65	$210.51
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $88.98 / $156.71 / $518.02	Professional	TC	$88.98	$156.71	$518.02
United Facility/Professional Professional Modifier Low / Median / High Price $125.23 / $223.41 / $400.27	Professional		$125.23	$223.41	$400.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.86 / $73.48 / $130.79	Professional	26	$41.86	$73.48	$130.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $83.37 / $151.43 / $277.56	Professional	TC	$83.37	$151.43	$277.56