Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.87 / $28.87 / $28.87	Facility	26	$28.87	$28.87	$28.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $86.41 / $109.28 / $182.07	Professional		$86.41	$109.28	$182.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.18 / $28.87 / $65.56	Professional	26	$24.18	$28.87	$65.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.22 / $79.20 / $113.44	Professional	TC	$62.22	$79.20	$113.44
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.90 / $23.90 / $23.90	Facility	26	$23.90	$23.90	$23.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $184.60 / $274.69 / $367.18	Professional		$184.60	$274.69	$367.18
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $49.50 / $73.72 / $98.54	Professional	26	$49.50	$73.72	$98.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.05 / $212.92 / $268.64	Professional	TC	$143.05	$212.92	$268.64
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.52 / $99.14 / $238.49	Facility	26	$63.52	$99.14	$238.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.59 / $206.25 / $340.95	Professional		$130.59	$206.25	$340.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.53 / $54.14 / $89.50	Professional	26	$36.53	$54.14	$89.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.72 / $152.11 / $249.35	Professional	TC	$94.72	$152.11	$249.35
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $55.05 / $90.47 / $187.79	Facility	26	$55.05	$90.47	$187.79
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $162.40 / $162.40 / $305.60	Professional		$162.40	$162.40	$305.60
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $42.63 / $42.63 / $80.22	Professional	26	$42.63	$42.63	$80.22
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $119.77 / $119.77 / $225.38	Professional	TC	$119.77	$119.77	$225.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $128.65 / $128.65 / $128.65	Facility	26	$128.65	$128.65	$128.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $201.28 / $539.53	Professional		$109.71	$201.28	$539.53
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $54.82 / $145.94	Professional	26	$30.32	$54.82	$145.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $79.39 / $143.30 / $393.58	Professional	TC	$79.39	$143.30	$393.58
United Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $194.14 / $351.81	Professional		$109.71	$194.14	$351.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.66 / $59.28 / $106.19	Professional	26	$30.66	$59.28	$106.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.39 / $141.63 / $256.64	Professional	TC	$79.39	$141.63	$256.64