Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.12 / $81.12 / $81.12	Facility	26	$81.12	$81.12	$81.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.62 / $84.31 / $365.40	Professional		$80.62	$84.31	$365.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.40 / $81.12 / $213.30	Professional	26	$63.40	$81.12	$213.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $27.04 / $60.81	Professional	TC	$18.55	$27.04	$60.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $179.61 / $272.66 / $420.11	Professional		$179.61	$272.66	$420.11
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $133.27 / $202.33 / $311.73	Professional	26	$133.27	$202.33	$311.73
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.33 / $74.48 / $108.38	Professional	TC	$46.33	$74.48	$108.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.24 / $616.35 / $738.46	Facility	26	$142.24	$616.35	$738.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.06 / $193.71 / $245.35	Professional		$154.06	$193.71	$245.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.00 / $143.35 / $181.56	Professional	26	$114.00	$143.35	$181.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $50.37 / $63.79	Professional	TC	$40.04	$50.37	$63.79
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $112.00 / $581.46 / $581.46	Facility	26	$112.00	$581.46	$581.46
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $152.53 / $152.53 / $218.23	Professional		$152.53	$152.53	$218.23
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $112.87 / $112.87 / $161.49	Professional	26	$112.87	$112.87	$161.49
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $39.65 / $39.65 / $56.74	Professional	TC	$39.65	$39.65	$56.74
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $390.55 / $390.55 / $390.55	Facility	26	$390.55	$390.55	$390.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $237.67 / $745.14	Professional		$104.98	$237.67	$745.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $72.01 / $180.22 / $538.00	Professional	26	$72.01	$180.22	$538.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $26.70 / $56.63 / $340.13	Professional	TC	$26.70	$56.63	$340.13
United Facility/Professional Professional Modifier Low / Median / High Price $104.98 / $234.18 / $408.03	Professional		$104.98	$234.18	$408.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $160.49 / $226.25	Professional	26	$72.09	$160.49	$226.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.70 / $51.98 / $82.22	Professional	TC	$26.70	$51.98	$82.22