Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $69.18 / $338.84	Facility		$63.10	$69.18	$338.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $61.66 / $158.49	Professional		$46.77	$61.66	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $25.12 / $34.67	Professional	26	$19.05	$25.12	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $48.98	Professional	TC	$25.12	$33.11	$48.98
BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $309.03 / $323.59	Facility		$60.26	$309.03	$323.59
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $24.55 / $24.55 / $24.55	Facility	26	$24.55	$24.55	$24.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $147.91 / $218.78	Professional		$91.20	$147.91	$218.78
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $63.10 / $91.20	Professional	26	$38.02	$63.10	$91.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $87.10 / $125.89	Professional	TC	$53.70	$87.10	$125.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $208.93 / $239.88	Facility		$151.36	$208.93	$239.88
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $87.10 / $100.00	Facility	26	$61.66	$87.10	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $147.91 / $251.19	Professional		$66.07	$147.91	$251.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $61.66 / $104.71	Professional	26	$26.30	$61.66	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $87.10 / $147.91	Professional	TC	$38.90	$87.10	$147.91
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $190.55 / $389.05	Facility		$151.36	$190.55	$389.05
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $77.62 / $162.18	Facility	26	$61.66	$77.62	$162.18
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $158.49 / $213.80	Professional		$95.50	$158.49	$213.80
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $66.07 / $89.13	Professional	26	$39.81	$66.07	$89.13
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $93.33 / $125.89	Professional	TC	$56.23	$93.33	$125.89
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $61.66 / $131.83	Facility		$40.74	$61.66	$131.83
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $107.15 / $239.88	Professional		$69.18	$107.15	$239.88
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $44.67 / $100.00	Professional	26	$25.12	$44.67	$100.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $57.54 / $141.25	Professional	TC	$32.36	$57.54	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $81.28 / $165.96	Professional		$56.23	$81.28	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $35.48 / $72.44	Professional	26	$24.55	$35.48	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $48.98 / $95.50	Professional	TC	$31.62	$48.98	$95.50