Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $121.57 / $121.57 / $121.57	Facility	26	$121.57	$121.57	$121.57
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $168.91 / $168.91 / $168.91	Facility	53	$168.91	$168.91	$168.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $731.63 / $906.25 / $1,214.31	Professional		$731.63	$906.25	$1,214.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.90 / $155.40 / $228.77	Professional	26	$111.90	$155.40	$228.77
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $352.75 / $422.27 / $519.00	Professional	52	$352.75	$422.27	$519.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $141.10 / $168.91 / $207.60	Professional	53	$141.10	$168.91	$207.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $621.72 / $767.25 / $925.03	Professional	TC	$621.72	$767.25	$925.03
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $94.16 / $94.16 / $94.16	Facility	26	$94.16	$94.16	$94.16
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,088.65 / $2,118.21 / $2,569.09	Professional		$1,088.65	$2,118.21	$2,569.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $171.22 / $319.18 / $387.12	Professional	26	$171.22	$319.18	$387.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,073.69 / $1,799.03 / $2,181.96	Professional	TC	$1,073.69	$1,799.03	$2,181.96
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $250.25 / $390.58 / $939.59	Facility	26	$250.25	$390.58	$939.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.30 / $163.30 / $163.30	Facility	53	$163.30	$163.30	$163.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $943.53 / $1,887.89 / $3,049.46	Professional		$943.53	$1,887.89	$3,049.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $163.69 / $294.66 / $471.02	Professional	26	$163.69	$294.66	$471.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $761.82 / $1,596.29 / $2,556.04	Professional	TC	$761.82	$1,596.29	$2,556.04
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $216.87 / $356.43 / $739.84	Facility	26	$216.87	$356.43	$739.84
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $1,274.81 / $1,942.13 / $2,769.00	Professional		$1,274.81	$1,942.13	$2,769.00
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $196.91 / $293.64 / $427.70	Professional	26	$196.91	$293.64	$427.70
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $1,077.90 / $1,642.15 / $2,341.30	Professional	TC	$1,077.90	$1,642.15	$2,341.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $879.50 / $1,759.26 / $5,332.25	Professional		$879.50	$1,759.26	$5,332.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $145.30 / $281.49 / $1,044.83	Professional	26	$145.30	$281.49	$1,044.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $1,488.25 / $4,416.72	Professional	TC	$747.41	$1,488.25	$4,416.72
United Facility/Professional Professional Modifier Low / Median / High Price $879.50 / $1,709.15 / $2,996.28	Professional		$879.50	$1,709.15	$2,996.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $132.09 / $268.00 / $450.00	Professional	26	$132.09	$268.00	$450.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $747.41 / $1,416.09 / $2,546.28	Professional	TC	$747.41	$1,416.09	$2,546.28