Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.97 / $561.85 / $804.08	Facility		$138.97	$561.85	$804.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.52 / $28.52 / $48.19	Facility	26	$28.52	$28.52	$48.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $64.13 / $178.13 / $484.79	Facility	TC	$64.13	$178.13	$484.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.93 / $107.95 / $559.00	Professional		$76.93	$107.95	$559.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.43 / $45.87 / $139.91	Professional	26	$25.43	$45.87	$139.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.76 / $71.45 / $166.43	Professional	TC	$51.76	$71.45	$166.43
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 $23.32 / $23.32 / $23.32	Facility	26	$23.32	$23.32	$23.32
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $51.83 / $51.83 / $51.83	Facility	TC	$51.83	$51.83	$51.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.41 / $229.05 / $306.18	Professional		$151.41	$229.05	$306.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.33 / $71.95 / $96.19	Professional	26	$48.33	$71.95	$96.19
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $109.36 / $166.43 / $209.98	Professional	TC	$109.36	$166.43	$209.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $201.27 / $314.14 / $755.70	Facility		$201.27	$314.14	$755.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.99 / $96.75 / $232.74	Facility	26	$61.99	$96.75	$232.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $139.28 / $217.39 / $522.95	Facility	TC	$139.28	$217.39	$522.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.18 / $168.87 / $279.16	Professional		$114.18	$168.87	$279.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.07 / $52.85 / $87.37	Professional	26	$35.07	$52.85	$87.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $78.55 / $116.01 / $191.79	Professional	TC	$78.55	$116.01	$191.79
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $174.42 / $286.67 / $595.04	Facility		$174.42	$286.67	$595.04
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $53.72 / $88.29 / $183.26	Facility	26	$53.72	$88.29	$183.26
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $120.70 / $198.38 / $411.78	Facility	TC	$120.70	$198.38	$411.78
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $132.97 / $132.97 / $250.21	Professional		$132.97	$132.97	$250.21
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $41.62 / $41.62 / $78.31	Professional	26	$41.62	$41.62	$78.31
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $91.35 / $91.35 / $171.90	Professional	TC	$91.35	$91.35	$171.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.15 / $283.72 / $530.87	Facility		$117.15	$283.72	$530.87
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $125.66 / $125.66 / $125.66	Facility	26	$125.66	$125.66	$125.66
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $275.00 / $495.76 / $607.96	Facility	TC	$275.00	$495.76	$607.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $102.85 / $223.46 / $521.73	Professional		$102.85	$223.46	$521.73
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $72.81 / $160.22	Professional	26	$38.43	$72.81	$160.22
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $69.08 / $118.30 / $390.02	Professional	TC	$69.08	$118.30	$390.02
United Facility/Professional Professional Modifier Low / Median / High Price $92.75 / $160.96 / $291.61	Professional		$92.75	$160.96	$291.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.75 / $57.32 / $104.90	Professional	26	$31.75	$57.32	$104.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.80 / $115.09 / $209.08	Professional	TC	$62.80	$115.09	$209.08