Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.60 / $448.40 / $969.15	Facility		$114.60	$448.40	$969.15
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.53 / $35.53 / $60.04	Facility	26	$35.53	$35.53	$60.04
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $79.06 / $79.06 / $349.05	Facility	TC	$79.06	$79.06	$349.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.87 / $133.18 / $594.70	Professional		$93.87	$133.18	$594.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.67 / $48.99 / $180.50	Professional	26	$31.67	$48.99	$180.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $41.54 / $56.97 / $74.55	Professional	52	$41.54	$56.97	$74.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.32 / $86.77 / $205.59	Professional	TC	$62.32	$86.77	$205.59
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 $29.08 / $29.08 / $29.08	Facility	26	$29.08	$29.08	$29.08
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $64.20 / $64.20 / $64.20	Facility	TC	$64.20	$64.20	$64.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $188.10 / $285.22 / $381.26	Professional		$188.10	$285.22	$381.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.56 / $91.27 / $122.00	Professional	26	$60.56	$91.27	$122.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.04 / $205.49 / $259.26	Professional	TC	$135.04	$205.49	$259.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $251.02 / $391.77 / $942.47	Facility		$251.02	$391.77	$942.47
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.06 / $121.83 / $293.08	Facility	26	$78.06	$121.83	$293.08
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $172.96 / $269.94 / $649.38	Facility	TC	$172.96	$269.94	$649.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.27 / $209.47 / $346.28	Professional		$145.27	$209.47	$346.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.90 / $65.73 / $108.68	Professional	26	$43.90	$65.73	$108.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.35 / $143.72 / $237.60	Professional	TC	$100.35	$143.72	$237.60
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $217.53 / $357.52 / $742.10	Facility		$217.53	$357.52	$742.10
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $67.65 / $107.42 / $230.78	Facility	26	$67.65	$107.42	$230.78
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $149.88 / $246.34 / $511.33	Facility	TC	$149.88	$246.34	$511.33
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $164.94 / $164.94 / $310.38	Professional		$164.94	$164.94	$310.38
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $51.77 / $51.77 / $97.41	Professional	26	$51.77	$51.77	$97.41
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $113.17 / $113.17 / $212.97	Professional	TC	$113.17	$113.17	$212.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $140.85 / $302.81 / $590.40	Facility		$140.85	$302.81	$590.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $157.44 / $157.44 / $157.44	Facility	26	$157.44	$157.44	$157.44
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $408.24 / $502.46 / $678.70	Facility	TC	$408.24	$502.46	$678.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $127.35 / $260.48 / $626.00	Professional		$127.35	$260.48	$626.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $45.04 / $81.90 / $195.25	Professional	26	$45.04	$81.90	$195.25
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $85.36 / $145.94 / $483.33	Professional	TC	$85.36	$145.94	$483.33
United Facility/Professional Professional Modifier Low / Median / High Price $115.13 / $207.17 / $377.99	Professional		$115.13	$207.17	$377.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.53 / $66.95 / $121.20	Professional	26	$37.53	$66.95	$121.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.00 / $146.81 / $254.43	Professional	TC	$80.00	$146.81	$254.43