Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.28 / $52.28 / $52.28	Facility		$52.28	$52.28	$52.28
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.17 / $33.17 / $33.17	Facility	26	$33.17	$33.17	$33.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.73 / $80.39 / $176.72	Professional		$43.73	$80.39	$176.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.10 / $31.57 / $69.29	Professional	26	$28.10	$31.57	$69.29
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $115.29 / $326.11 / $334.86	Professional	50	$115.29	$326.11	$334.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $21.00 / $26.14 / $37.79	Professional	52	$21.00	$26.14	$37.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.89 / $32.35 / $106.51	Professional	TC	$15.89	$32.35	$106.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.66 / $237.27 / $453.98	Facility		$120.66	$237.27	$453.98
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $25.33 / $25.33 / $25.33	Facility	26	$25.33	$25.33	$25.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.16 / $122.37 / $165.41	Professional		$73.16	$122.37	$165.41
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.18 / $77.73 / $104.41	Professional	26	$46.18	$77.73	$104.41
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.03 / $48.79 / $61.00	Professional	TC	$30.03	$48.79	$61.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.91 / $168.42 / $405.15	Facility		$107.91	$168.42	$405.15
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.11 / $106.30 / $255.73	Facility	26	$68.11	$106.30	$255.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $130.27 / $202.86	Professional		$74.77	$130.27	$202.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $82.23 / $128.05	Professional	26	$33.79	$82.23	$128.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.54 / $53.49 / $76.00	Professional	TC	$29.54	$53.49	$76.00
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $93.51 / $148.49 / $319.01	Facility		$93.51	$148.49	$319.01
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $59.02 / $93.73 / $201.36	Facility	26	$59.02	$93.73	$201.36
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $126.77 / $183.30	Professional		$79.86	$126.77	$183.30
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $50.41 / $80.02 / $115.70	Professional	26	$50.41	$80.02	$115.70
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $29.45 / $46.75 / $67.59	Professional	TC	$29.45	$46.75	$67.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.28 / $98.67 / $182.38	Facility		$52.28	$98.67	$182.38
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $134.74 / $134.74 / $134.74	Facility	26	$134.74	$134.74	$134.74
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.39 / $142.32 / $459.15	Professional		$69.39	$142.32	$459.15
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $60.35 / $188.73	Professional	26	$31.76	$60.35	$188.73
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $31.76 / $82.30 / $313.58	Professional	TC	$31.76	$82.30	$313.58
United Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $128.55 / $196.28	Professional		$63.52	$128.55	$196.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $59.02 / $102.61	Professional	26	$31.76	$59.02	$102.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.04 / $73.37 / $112.73	Professional	TC	$29.04	$73.37	$112.73