Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.61 / $350.55 / $792.00	Facility		$78.61	$350.55	$792.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.99 / $10.99 / $10.99	Facility	26	$10.99	$10.99	$10.99
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $67.62 / $67.62 / $67.62	Facility	TC	$67.62	$67.62	$67.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.21 / $78.61 / $152.37	Professional		$42.21	$78.61	$152.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.99 / $26.54 / $96.12	Professional	26	$10.99	$26.54	$96.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.09 / $67.62 / $132.57	Professional	TC	$45.09	$67.62	$132.57
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 $129.63 / $196.79 / $303.20	Professional		$129.63	$196.79	$303.20
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $18.22 / $27.66 / $42.62	Professional	26	$18.22	$27.66	$42.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.41 / $178.52 / $260.58	Professional	TC	$111.41	$178.52	$260.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.47 / $604.36 / $724.09	Facility		$139.47	$604.36	$724.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.82 / $81.54 / $97.69	Facility	26	$18.82	$81.54	$97.69
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $120.65 / $522.82 / $626.40	Facility	TC	$120.65	$522.82	$626.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.60 / $137.81 / $174.55	Professional		$109.60	$137.81	$174.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.97 / $18.82 / $23.83	Professional	26	$14.97	$18.82	$23.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.63 / $119.00 / $150.72	Professional	TC	$94.63	$119.00	$150.72
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $109.82 / $570.15 / $570.15	Facility		$109.82	$570.15	$570.15
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $14.82 / $76.93 / $76.93	Facility	26	$14.82	$76.93	$76.93
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $95.00 / $493.23 / $493.23	Facility	TC	$95.00	$493.23	$493.23
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $108.51 / $108.51 / $155.25	Professional		$108.51	$108.51	$155.25
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $14.82 / $14.82 / $21.20	Professional	26	$14.82	$14.82	$21.20
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $93.70 / $93.70 / $134.05	Professional	TC	$93.70	$93.70	$134.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.36 / $98.09 / $253.40	Facility		$38.36	$98.09	$253.40
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 $319.41 / $319.41 / $319.41	Facility	TC	$319.41	$319.41	$319.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.34 / $133.93 / $514.55	Professional		$46.34	$133.93	$514.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.24 / $38.43 / $59.52	Professional	26	$21.24	$38.43	$59.52
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $46.34 / $125.76 / $439.92	Professional	TC	$46.34	$125.76	$439.92
United Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $128.18 / $223.97	Professional		$56.97	$128.18	$223.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.91 / $21.99 / $33.17	Professional	26	$9.91	$21.99	$33.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.06 / $111.78 / $224.05	Professional	TC	$47.06	$111.78	$224.05