Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $44.67	Facility	26	$25.70	$25.70	$44.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $112.20 / $407.38	Professional		$81.28	$112.20	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $33.88 / $93.33	Professional	26	$21.88	$33.88	$93.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $81.28 / $177.83	Professional	TC	$58.88	$81.28	$177.83
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $21.88 / $21.88	Facility	26	$19.05	$21.88	$21.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $380.19	Professional		$173.78	$257.04	$380.19
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $61.66 / $91.20	Professional	26	$42.66	$61.66	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $288.40	Professional	TC	$131.83	$204.17	$288.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.89 / $81.28 / $223.87	Facility	26	$20.89	$81.28	$223.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $190.55 / $323.59	Professional		$104.71	$190.55	$323.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $47.86 / $75.86	Professional	26	$30.20	$47.86	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $144.54 / $251.19	Professional	TC	$75.86	$144.54	$251.19
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $72.44 / $91.20 / $177.83	Facility	26	$72.44	$91.20	$177.83
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $257.04	Professional		$162.18	$162.18	$257.04
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $58.88	Professional	26	$38.02	$38.02	$58.88
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $125.89 / $194.98	Professional	TC	$125.89	$125.89	$194.98
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $190.55 / $602.56	Professional		$100.00	$190.55	$602.56
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $52.48 / $144.54	Professional	26	$28.18	$52.48	$144.54
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $128.82 / $524.81	Professional	TC	$74.13	$128.82	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $169.82 / $331.13	Professional		$107.15	$169.82	$331.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $46.77 / $81.28	Professional	26	$28.18	$46.77	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $125.89 / $251.19	Professional	TC	$81.28	$125.89	$251.19