Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.23 / $33.79 / $50.68	Facility	26	$31.23	$33.79	$50.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.75 / $171.34 / $537.70	Professional		$104.75	$171.34	$537.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.75 / $53.59 / $150.10	Professional	26	$29.75	$53.59	$150.10
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.66 / $62.25 / $90.74	Professional	52	$45.66	$62.25	$90.74
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.98 / $94.62 / $242.97	Professional	TC	$74.98	$94.62	$242.97
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $27.63 / $27.63 / $27.63	Facility	26	$27.63	$27.63	$27.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $205.56 / $316.23 / $419.97	Professional		$205.56	$316.23	$419.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.07 / $85.13 / $113.79	Professional	26	$57.07	$85.13	$113.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $159.46 / $241.84 / $306.18	Professional	TC	$159.46	$241.84	$306.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.47 / $114.67 / $275.83	Facility	26	$73.47	$114.67	$275.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.58 / $230.10 / $380.38	Professional		$147.58	$230.10	$380.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.51 / $62.52 / $103.35	Professional	26	$41.51	$62.52	$103.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.72 / $167.58 / $277.02	Professional	TC	$104.72	$167.58	$277.02
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $63.67 / $104.64 / $217.20	Facility	26	$63.67	$104.64	$217.20
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $181.18 / $181.18 / $351.68	Professional		$181.18	$181.18	$351.68
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $49.23 / $49.23 / $99.38	Professional	26	$49.23	$49.23	$99.38
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $131.94 / $131.94 / $256.13	Professional	TC	$131.94	$131.94	$256.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $148.36 / $148.36 / $148.36	Facility	26	$148.36	$148.36	$148.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $150.28 / $334.48 / $557.07	Professional		$150.28	$334.48	$557.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $42.45 / $88.65 / $181.33	Professional	26	$42.45	$88.65	$181.33
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $177.30 / $177.30 / $178.76	Professional	52	$177.30	$177.30	$178.76
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $92.83 / $180.77 / $530.23	Professional	TC	$92.83	$180.77	$530.23
United Facility/Professional Professional Modifier Low / Median / High Price $87.90 / $202.37 / $448.53	Professional		$87.90	$202.37	$448.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.36 / $62.07 / $111.41	Professional	26	$35.36	$62.07	$111.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.86 / $162.99 / $297.52	Professional	TC	$89.86	$162.99	$297.52