Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.97 / $215.80 / $823.43	Facility		$107.97	$215.80	$823.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.45 / $24.45 / $24.45	Facility	26	$24.45	$24.45	$24.45
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $83.52 / $83.52 / $83.52	Facility	TC	$83.52	$83.52	$83.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.93 / $78.06 / $184.46	Professional		$54.93	$78.06	$184.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.73 / $60.91 / $214.70	Professional	26	$19.73	$60.91	$214.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.43 / $81.63 / $231.40	Professional	TC	$44.43	$81.63	$231.40
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 $175.96 / $267.13 / $411.58	Professional		$175.96	$267.13	$411.58
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $40.09 / $60.85 / $93.76	Professional	26	$40.09	$60.85	$93.76
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $135.88 / $217.73 / $317.82	Professional	TC	$135.88	$217.73	$317.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.40 / $825.00 / $988.44	Facility		$190.40	$825.00	$988.44
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.62 / $184.67 / $221.25	Facility	26	$42.62	$184.67	$221.25
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $147.78 / $640.33 / $767.19	Facility	TC	$147.78	$640.33	$767.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.65 / $188.18 / $238.34	Professional		$149.65	$188.18	$238.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.89 / $42.62 / $53.98	Professional	26	$33.89	$42.62	$53.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $115.76 / $145.56 / $184.36	Professional	TC	$115.76	$145.56	$184.36
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $149.91 / $778.30 / $778.30	Facility		$149.91	$778.30	$778.30
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $33.56 / $174.21 / $174.21	Facility	26	$33.56	$174.21	$174.21
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $116.36 / $604.09 / $604.09	Facility	TC	$116.36	$604.09	$604.09
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $148.16 / $148.16 / $211.99	Professional		$148.16	$148.16	$211.99
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $33.56 / $48.01	Professional	26	$33.56	$33.56	$48.01
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $114.62 / $114.62 / $163.98	Professional	TC	$114.62	$114.62	$163.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.22 / $178.09 / $290.72	Facility		$51.22	$178.09	$290.72
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $116.58 / $116.58 / $116.58	Facility	26	$116.58	$116.58	$116.58
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	TC	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $87.95 / $192.56 / $435.23	Professional		$87.95	$192.56	$435.23
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $47.22 / $82.03 / $110.67	Professional	26	$47.22	$82.03	$110.67
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $57.01 / $167.45 / $552.78	Professional	TC	$57.01	$167.45	$552.78
United Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $201.14 / $371.76	Professional		$80.45	$201.14	$371.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.67 / $50.18 / $72.98	Professional	26	$16.67	$50.18	$72.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $57.86 / $130.18 / $230.26	Professional	TC	$57.86	$130.18	$230.26