Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.86 / $336.76 / $871.47	Facility		$82.86	$336.76	$871.47
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.06 / $26.06 / $26.06	Facility	26	$26.06	$26.06	$26.06
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $56.80 / $56.80 / $56.80	Facility	TC	$56.80	$56.80	$56.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.79 / $82.86 / $232.20	Professional		$53.79	$82.86	$232.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.93 / $127.30 / $707.75	Professional	26	$25.93	$127.30	$707.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.46 / $88.38 / $388.08	Professional	TC	$29.46	$88.38	$388.08
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 $145.10 / $214.97 / $331.21	Professional		$145.10	$214.97	$331.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.17 / $64.01 / $98.63	Professional	26	$42.17	$64.01	$98.63
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $98.82 / $159.33 / $223.74	Professional	TC	$98.82	$159.33	$223.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.76 / $661.92 / $793.05	Facility		$152.76	$661.92	$793.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.83 / $194.26 / $232.74	Facility	26	$44.83	$194.26	$232.74
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $107.92 / $467.66 / $560.30	Facility	TC	$107.92	$467.66	$560.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.41 / $162.72 / $206.09	Professional		$129.41	$162.72	$206.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.09 / $45.38 / $57.48	Professional	26	$36.09	$45.38	$57.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $93.31 / $117.33 / $148.61	Professional	TC	$93.31	$117.33	$148.61
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $120.28 / $624.45 / $624.45	Facility		$120.28	$624.45	$624.45
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $35.29 / $183.26 / $183.26	Facility	26	$35.29	$183.26	$183.26
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $84.98 / $441.19 / $441.19	Facility	TC	$84.98	$441.19	$441.19
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $128.13 / $128.13 / $183.31	Professional		$128.13	$128.13	$183.31
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $35.74 / $35.74 / $51.13	Professional	26	$35.74	$35.74	$51.13
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $92.39 / $92.39 / $132.18	Professional	TC	$92.39	$92.39	$132.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.48 / $124.39 / $258.50	Facility		$66.48	$124.39	$258.50
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $124.11 / $124.11 / $124.11	Facility	26	$124.11	$124.11	$124.11
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $313.37 / $313.37 / $313.37	Facility	TC	$313.37	$313.37	$313.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.33 / $165.00 / $346.72	Professional		$79.33	$165.00	$346.72
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $51.72 / $92.02 / $128.61	Professional	26	$51.72	$92.02	$128.61
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.95 / $126.90 / $283.95	Professional	TC	$49.95	$126.90	$283.95
United Facility/Professional Professional Modifier Low / Median / High Price $74.52 / $165.46 / $247.39	Professional		$74.52	$165.46	$247.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.76 / $33.04 / $77.72	Professional	26	$23.76	$33.04	$77.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.76 / $77.52 / $159.56	Professional	TC	$50.76	$77.52	$159.56