Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $338.84 / $549.54	Facility		$112.20	$338.84	$549.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $467.74	Professional		$85.11	$125.89	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $125.89 / $660.69	Professional	26	$33.11	$125.89	$660.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $70.79 / $158.49	Professional	TC	$50.12	$70.79	$158.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $302.00 / $407.38	Professional		$194.98	$302.00	$407.38
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $104.71 / $138.04	Professional	26	$66.07	$104.71	$138.04
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $213.80 / $275.42	Professional	TC	$128.82	$213.80	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $912.01 / $1,096.48	Facility		$66.07	$912.01	$1,096.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $302.00 / $363.08	Facility	26	$66.07	$302.00	$363.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $199.53 / $257.04	Professional		$158.49	$199.53	$257.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $66.07 / $85.11	Professional	26	$52.48	$66.07	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $134.90 / $169.82	Professional	TC	$107.15	$134.90	$169.82
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $870.96 / $870.96	Facility		$52.48	$870.96	$870.96
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $281.84 / $281.84	Facility	26	$52.48	$281.84	$281.84
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $354.81	Professional		$158.49	$158.49	$354.81
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $52.48 / $151.36	Professional	26	$52.48	$52.48	$151.36
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $104.71 / $204.17	Professional	TC	$104.71	$104.71	$204.17
Medica Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $234.42 / $380.19	Facility		$154.88	$234.42	$380.19
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $223.87 / $223.87 / $223.87	Facility	26	$223.87	$223.87	$223.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $281.84 / $645.65	Professional		$112.20	$281.84	$645.65
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $123.03 / $213.80	Professional	26	$70.79	$123.03	$213.80
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $169.82 / $512.86	Professional	TC	$50.12	$169.82	$512.86
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $251.19 / $407.38	Professional		$114.82	$251.19	$407.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $87.10 / $134.90	Professional	26	$42.66	$87.10	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $162.18 / $269.15	Professional	TC	$69.18	$162.18	$269.15