Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.58 / $96.97 / $741.00	Facility		$92.58	$96.97	$741.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.26 / $57.26 / $57.26	Facility	26	$57.26	$57.26	$57.26
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.70 / $39.70 / $39.70	Facility	TC	$39.70	$39.70	$39.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $96.97 / $170.78	Professional		$69.84	$96.97	$170.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.47 / $307.80 / $2,154.60	Professional	26	$45.47	$307.80	$2,154.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.37 / $33.15 / $70.75	Professional	TC	$24.37	$33.15	$70.75
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 $144.16 / $239.47 / $354.93	Professional		$144.16	$239.47	$354.93
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.19 / $141.47 / $217.97	Professional	26	$93.19	$141.47	$217.97
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $63.33 / $103.44 / $150.99	Professional	TC	$63.33	$103.44	$150.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $168.81 / $731.47 / $876.38	Facility		$168.81	$731.47	$876.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.07 / $429.29 / $514.33	Facility	26	$99.07	$429.29	$514.33
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $69.73 / $302.18 / $362.05	Facility	TC	$69.73	$302.18	$362.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.81 / $168.25 / $213.10	Professional		$133.81	$168.25	$213.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.23 / $99.62 / $126.18	Professional	26	$79.23	$99.62	$126.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.58 / $68.63 / $86.92	Professional	TC	$54.58	$68.63	$86.92
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $132.91 / $690.06 / $690.06	Facility		$132.91	$690.06	$690.06
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $78.01 / $404.99 / $404.99	Facility	26	$78.01	$404.99	$404.99
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $54.91 / $285.08 / $285.08	Facility	TC	$54.91	$285.08	$285.08
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $132.47 / $132.47 / $189.54	Professional		$132.47	$132.47	$189.54
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $78.44 / $78.44 / $112.23	Professional	26	$78.44	$78.44	$112.23
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $54.04 / $54.04 / $77.31	Professional	TC	$54.04	$54.04	$77.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $98.46 / $166.74 / $236.30	Facility		$98.46	$166.74	$236.30
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $272.47 / $272.47 / $272.47	Facility	26	$272.47	$272.47	$272.47
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $184.67 / $184.67 / $184.67	Facility	TC	$184.67	$184.67	$184.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $187.38 / $643.49	Professional		$78.43	$187.38	$643.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $87.52 / $219.09 / $309.69	Professional	26	$87.52	$219.09	$309.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $25.96 / $65.88 / $350.03	Professional	TC	$25.96	$65.88	$350.03
United Facility/Professional Professional Modifier Low / Median / High Price $78.43 / $175.17 / $263.51	Professional		$78.43	$175.17	$263.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.19 / $116.66 / $171.56	Professional	26	$39.19	$116.66	$171.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.35 / $68.15 / $125.51	Professional	TC	$26.35	$68.15	$125.51