Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.78 / $69.78 / $69.78	Facility		$69.78	$69.78	$69.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.40 / $29.40 / $29.40	Facility	26	$29.40	$29.40	$29.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $71.14 / $144.88	Professional		$56.27	$71.14	$144.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.22 / $28.98 / $63.87	Professional	26	$23.22	$28.98	$63.87
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $26.14 / $34.89 / $40.25	Professional	52	$26.14	$34.89	$40.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.05 / $40.38 / $62.82	Professional	TC	$29.05	$40.38	$62.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.08 / $57.08 / $57.08	Facility		$57.08	$57.08	$57.08
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $23.44 / $23.44	Facility	26	$23.44	$23.44	$23.44
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.06 / $170.50 / $222.89	Professional		$98.06	$170.50	$222.89
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.36 / $73.45 / $92.67	Professional	26	$42.36	$73.45	$92.67
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.24 / $104.15 / $130.21	Professional	TC	$62.24	$104.15	$130.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.94 / $183.86 / $231.18	Facility		$146.94	$183.86	$231.18
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.46 / $75.65 / $95.12	Facility	26	$60.46	$75.65	$95.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.28 / $156.26 / $255.04	Professional		$74.28	$156.26	$255.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.72 / $64.63 / $105.49	Professional	26	$30.72	$64.63	$105.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.56 / $91.63 / $149.55	Professional	TC	$43.56	$91.63	$149.55
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $146.94 / $182.04 / $381.91	Facility		$146.94	$182.04	$381.91
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $60.46 / $74.90 / $157.13	Facility	26	$60.46	$74.90	$157.13
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $152.30 / $219.80	Professional		$88.93	$152.30	$219.80
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $36.78 / $62.99 / $90.91	Professional	26	$36.78	$62.99	$90.91
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $52.15 / $89.31 / $128.88	Professional	TC	$52.15	$89.31	$128.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.05 / $64.88 / $135.13	Facility		$41.05	$64.88	$135.13
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $152.15 / $152.15 / $152.15	Facility	26	$152.15	$152.15	$152.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $106.00 / $236.98	Professional		$64.23	$106.00	$236.98
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.95 / $43.63 / $100.56	Professional	26	$24.95	$43.63	$100.56
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.44 / $55.94 / $142.68	Professional	TC	$32.44	$55.94	$142.68
United Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $89.94 / $186.30	Professional		$55.75	$89.94	$186.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.49 / $36.77 / $81.64	Professional	26	$24.49	$36.77	$81.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.71 / $48.50 / $101.41	Professional	TC	$31.71	$48.50	$101.41