Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.30 / $253.94 / $543.82	Facility		$113.30	$253.94	$543.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.54 / $38.54 / $38.54	Facility	26	$38.54	$38.54	$38.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $104.13 / $276.30	Professional		$69.73	$104.13	$276.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.75 / $43.23 / $220.40	Professional	26	$25.75	$43.23	$220.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.21 / $58.23 / $100.42	Professional	TC	$50.21	$58.23	$100.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.38 / $134.50 / $156.27	Facility		$134.38	$134.50	$156.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $170.43 / $285.31 / $422.88	Professional		$170.43	$285.31	$422.88
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $62.47 / $94.84 / $146.12	Professional	26	$62.47	$94.84	$146.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.46 / $201.04 / $293.47	Professional	TC	$125.46	$201.04	$293.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.57 / $877.76 / $1,051.66	Facility		$202.57	$877.76	$1,051.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.42 / $287.79 / $344.81	Facility	26	$66.42	$287.79	$344.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.34 / $200.35 / $253.76	Professional		$159.34	$200.35	$253.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.82 / $66.42 / $84.12	Professional	26	$52.82	$66.42	$84.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $106.52 / $133.94 / $169.64	Professional	TC	$106.52	$133.94	$169.64
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $159.50 / $828.08 / $828.08	Facility		$159.50	$828.08	$828.08
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $52.30 / $271.50 / $271.50	Facility	26	$52.30	$271.50	$271.50
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $157.76 / $157.76 / $225.71	Professional		$157.76	$157.76	$225.71
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $52.30 / $52.30 / $74.81	Professional	26	$52.30	$52.30	$74.81
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $105.46 / $105.46 / $150.88	Professional	TC	$105.46	$105.46	$150.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.21 / $234.42 / $379.67	Facility		$117.21	$234.42	$379.67
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $221.64 / $221.64 / $221.64	Facility	26	$221.64	$221.64	$221.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $119.28 / $283.26 / $592.24	Professional		$119.28	$283.26	$592.24
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.40 / $128.04 / $214.20	Professional	26	$71.40	$128.04	$214.20
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $67.62 / $171.62 / $507.20	Professional	TC	$67.62	$171.62	$507.20
United Facility/Professional Professional Modifier Low / Median / High Price $114.42 / $254.04 / $337.06	Professional		$114.42	$254.04	$337.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.95 / $89.49 / $127.69	Professional	26	$43.95	$89.49	$127.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $67.62 / $100.04 / $218.97	Professional	TC	$67.62	$100.04	$218.97