Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $194.98 / $323.59	Facility		$64.57	$194.98	$323.59
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $25.12	Facility	26	$25.12	$25.12	$25.12
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	TC	$38.02	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $63.10 / $275.42	Professional		$51.29	$63.10	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $37.15 / $194.98	Professional	26	$21.88	$37.15	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $38.02 / $77.62	Professional	TC	$27.54	$38.02	$77.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $173.78 / $234.42	Professional		$112.20	$173.78	$234.42
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $67.61 / $91.20	Professional	26	$43.65	$67.61	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $151.36	Professional	TC	$67.61	$112.20	$151.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $512.86 / $616.60	Facility		$41.69	$512.86	$616.60
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $199.53 / $239.88	Facility	26	$41.69	$199.53	$239.88
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $316.23 / $380.19	Facility	TC	$41.69	$316.23	$380.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $151.36	Professional		$85.11	$107.15	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $41.69 / $58.88	Professional	26	$33.11	$41.69	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $66.07 / $91.20	Professional	TC	$52.48	$66.07	$91.20
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $489.78 / $489.78	Facility		$33.11	$489.78	$489.78
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $190.55 / $190.55	Facility	26	$33.11	$190.55	$190.55
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $33.11 / $295.12 / $295.12	Facility	TC	$33.11	$295.12	$295.12
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $165.96	Professional		$85.11	$85.11	$165.96
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $77.62	Professional	26	$33.11	$33.11	$77.62
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $51.29 / $91.20	Professional	TC	$51.29	$51.29	$91.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $147.91 / $204.17	Facility		$107.15	$147.91	$204.17
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $234.42 / $234.42	Facility	26	$234.42	$234.42	$234.42
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $186.21 / $186.21 / $186.21	Facility	TC	$186.21	$186.21	$186.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $134.90 / $645.65	Professional		$54.95	$134.90	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $85.11 / $190.55	Professional	26	$47.86	$85.11	$190.55
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $77.62 / $309.03	Professional	TC	$25.70	$77.62	$309.03
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $131.83 / $229.09	Professional		$54.95	$131.83	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $53.70 / $89.13	Professional	26	$23.44	$53.70	$89.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $75.86 / $138.04	Professional	TC	$32.36	$75.86	$138.04