Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.79 / $202.00 / $856.18	Facility		$40.79	$202.00	$856.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.77 / $13.77 / $13.77	Facility	26	$13.77	$13.77	$13.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $36.79 / $66.81	Professional		$30.91	$36.79	$66.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $15.24 / $82.32	Professional	26	$12.30	$15.24	$82.32
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $22.26 / $37.92	Professional	TC	$17.89	$22.26	$37.92
BCBS Facility/Professional Facility Modifier Low / Median / High Price $0.98 / $32.82 / $1,536.50	Facility		$0.98	$32.82	$1,536.50
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $10.94 / $10.94 / $10.94	Facility	26	$10.94	$10.94	$10.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.97 / $101.42 / $134.91	Professional		$66.97	$101.42	$134.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.29 / $36.56 / $48.10	Professional	26	$23.29	$36.56	$48.10
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $48.38 / $71.41 / $86.81	Professional	TC	$48.38	$71.41	$86.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.24 / $136.16 / $327.56	Facility		$87.24	$136.16	$327.56
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.85 / $46.58 / $112.06	Facility	26	$29.85	$46.58	$112.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.43 / $74.12 / $124.07	Professional		$46.43	$74.12	$124.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.75 / $25.14 / $42.42	Professional	26	$18.75	$25.14	$42.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.14 / $48.98 / $81.99	Professional	TC	$27.14	$48.98	$81.99
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $75.59 / $120.05 / $257.93	Facility		$75.59	$120.05	$257.93
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $25.86 / $38.71 / $88.24	Facility	26	$25.86	$38.71	$88.24
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $61.57 / $117.82	Professional		$58.36	$61.57	$117.82
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.79 / $20.88 / $39.96	Professional	26	$19.79	$20.88	$39.96
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $38.57 / $40.69 / $77.86	Professional	TC	$38.57	$40.69	$77.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.77 / $74.36 / $417.92	Facility		$39.77	$74.36	$417.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $26.79 / $26.79 / $100.00	Facility	26	$26.79	$26.79	$100.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.17 / $66.31 / $287.00	Professional		$37.17	$66.31	$287.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $16.28 / $30.84 / $90.90	Professional	26	$16.28	$30.84	$90.90
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $22.37 / $39.90 / $230.00	Professional	TC	$22.37	$39.90	$230.00
United Facility/Professional Professional Modifier Low / Median / High Price $37.17 / $63.12 / $128.53	Professional		$37.17	$63.12	$128.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.54 / $26.40 / $49.27	Professional	26	$15.54	$26.40	$49.27
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.92 / $34.46 / $74.48	Professional	TC	$20.92	$34.46	$74.48