Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.65 / $386.46 / $903.36	Facility		$177.65	$386.46	$903.36
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.38 / $34.38 / $34.38	Facility	26	$34.38	$34.38	$34.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.54 / $33.54 / $33.54	Facility	TC	$33.54	$33.54	$33.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $76.58 / $269.93	Professional		$51.86	$76.58	$269.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $70.47 / $400.90	Professional	26	$31.70	$70.47	$400.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.84 / $25.93 / $33.96	Professional	52	$23.84	$25.93	$33.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.37 / $36.77 / $175.75	Professional	TC	$28.37	$36.77	$175.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.68 / $92.77 / $107.78	Facility		$92.68	$92.77	$107.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.64 / $169.79 / $251.85	Professional		$102.64	$169.79	$251.85
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $85.36 / $131.51	Professional	26	$56.22	$85.36	$131.51
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $57.33 / $87.47 / $125.34	Professional	TC	$57.33	$87.47	$125.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.10 / $520.41 / $623.52	Facility		$120.10	$520.41	$623.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $59.78 / $259.01 / $310.32	Facility	26	$59.78	$259.01	$310.32
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $60.33 / $261.41 / $313.20	Facility	TC	$60.33	$261.41	$313.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.51 / $120.10 / $154.08	Professional		$95.51	$120.10	$154.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.54 / $59.77 / $76.68	Professional	26	$47.54	$59.77	$76.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.98 / $60.33 / $74.86	Professional	TC	$47.98	$60.33	$74.86
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $94.57 / $490.96 / $490.96	Facility		$94.57	$490.96	$490.96
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $47.07 / $244.35 / $244.35	Facility	26	$47.07	$244.35	$244.35
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $47.50 / $246.61 / $246.61	Facility	TC	$47.50	$246.61	$246.61
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $94.57 / $94.57 / $141.90	Professional		$94.57	$94.57	$141.90
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $47.07 / $47.07 / $70.62	Professional	26	$47.07	$47.07	$70.62
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $47.48 / $47.50 / $71.28	Professional	TC	$47.48	$47.50	$71.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.09 / $124.61 / $218.92	Facility		$71.09	$124.61	$218.92
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	26	$163.47	$163.47	$163.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $216.27 / $216.27 / $216.27	Facility	TC	$216.27	$216.27	$216.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.81 / $147.00 / $275.07	Professional		$79.81	$147.00	$275.07
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $82.25 / $120.73 / $204.43	Professional	26	$82.25	$120.73	$204.43
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.11 / $122.00 / $175.57	Professional	TC	$32.11	$122.00	$175.57
United Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $125.24 / $187.69	Professional		$55.31	$125.24	$187.69
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.65 / $71.20 / $103.33	Professional	26	$31.65	$71.20	$103.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $62.53 / $111.40	Professional	TC	$24.01	$62.53	$111.40