Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $173.78 / $407.38	Facility		$74.13	$173.78	$407.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $10.00 / $10.00	Facility	26	$10.00	$10.00	$10.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $57.54 / $239.88	Professional		$29.51	$57.54	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $25.12 / $97.72	Professional	26	$8.91	$25.12	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $48.98 / $186.21	Professional	TC	$22.91	$48.98	$186.21
BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $147.91	Professional		$69.18	$107.15	$147.91
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $28.18 / $38.02	Professional	26	$18.20	$28.18	$38.02
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $85.11 / $109.65	Professional	TC	$52.48	$85.11	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.78 / $323.59 / $389.05	Facility		$17.78	$323.59	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.78 / $79.43 / $95.50	Facility	26	$17.78	$79.43	$95.50
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $17.78 / $245.47 / $288.40	Facility	TC	$17.78	$245.47	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $70.79 / $93.33	Professional		$56.23	$70.79	$93.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.13 / $17.78 / $22.91	Professional	26	$14.13	$17.78	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $53.70 / $69.18	Professional	TC	$42.66	$53.70	$69.18
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $13.80 / $302.00 / $302.00	Facility		$13.80	$302.00	$302.00
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $75.86 / $75.86	Facility	26	$13.80	$75.86	$75.86
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $13.80 / $229.09 / $229.09	Facility	TC	$13.80	$229.09	$229.09
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $56.23 / $100.00	Professional		$56.23	$56.23	$100.00
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $13.80 / $33.88	Professional	26	$13.80	$13.80	$33.88
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $41.69 / $67.61	Professional	TC	$41.69	$41.69	$67.61
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $69.18 / $158.49	Facility		$51.29	$69.18	$158.49
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	TC	$165.96	$165.96	$165.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $81.28 / $263.03	Professional		$34.67	$81.28	$263.03
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $34.67 / $114.82	Professional	26	$21.38	$34.67	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $74.13 / $269.15	Professional	TC	$23.44	$74.13	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $79.43 / $144.54	Professional		$33.11	$79.43	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $21.88 / $36.31	Professional	26	$9.55	$21.88	$36.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $58.88 / $104.71	Professional	TC	$23.99	$58.88	$104.71