Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.36 / $41.36 / $193.00	Facility		$41.36	$41.36	$193.00
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.01 / $23.01 / $23.01	Facility	26	$23.01	$23.01	$23.01
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $18.35 / $18.35 / $345.69	Facility	TC	$18.35	$18.35	$345.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $69.45 / $152.00	Professional		$34.54	$69.45	$152.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.59 / $71.59 / $71.59	Professional	25	$71.59	$71.59	$71.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.47 / $23.52 / $51.88	Professional	26	$19.47	$23.52	$51.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $89.26 / $234.74 / $234.74	Professional	50	$89.26	$234.74	$234.74
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.30 / $20.68 / $37.61	Professional	52	$16.30	$20.68	$37.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.41 / $26.35 / $97.50	Professional	TC	$15.41	$26.35	$97.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.14 / $205.67 / $453.98	Facility		$87.14	$205.67	$453.98
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $17.27 / $17.27 / $17.27	Facility	26	$17.27	$17.27	$17.27
BCBS Facility/Professional Facility Modifier TC Low / Median / High Price $14.10 / $14.10 / $14.10	Facility	TC	$14.10	$14.10	$14.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.07 / $107.36 / $130.21	Professional		$57.07	$107.36	$130.21
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.68 / $59.00 / $71.56	Professional	26	$32.68	$59.00	$71.56
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.19 / $48.37 / $58.66	Professional	TC	$29.19	$48.37	$58.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.95 / $132.58 / $318.94	Facility		$84.95	$132.58	$318.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.68 / $72.86 / $175.28	Facility	26	$46.68	$72.86	$175.28
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $38.27 / $59.72 / $143.66	Facility	TC	$38.27	$59.72	$143.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.03 / $101.58 / $157.47	Professional		$57.03	$101.58	$157.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.24 / $53.99 / $86.34	Professional	26	$23.24	$53.99	$86.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.29 / $48.45 / $71.61	Professional	TC	$26.29	$48.45	$71.61
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $73.62 / $120.99 / $251.14	Facility		$73.62	$120.99	$251.14
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $40.46 / $64.23 / $138.01	Facility	26	$40.46	$64.23	$138.01
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $33.15 / $54.50 / $113.13	Facility	TC	$33.15	$54.50	$113.13
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $99.68 / $143.00	Professional		$65.84	$99.68	$143.00
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $36.51 / $54.78 / $79.30	Professional	26	$36.51	$54.78	$79.30
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $29.33 / $44.68 / $63.70	Professional	TC	$29.33	$44.68	$63.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.03 / $80.41 / $175.22	Facility		$41.03	$80.41	$175.22
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $141.03 / $141.03 / $141.03	Facility	TC	$141.03	$141.03	$141.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $105.15 / $402.37	Professional		$45.83	$105.15	$402.37
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $41.48 / $130.60	Professional	26	$22.01	$41.48	$130.60
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $61.58 / $284.52	Professional	TC	$23.82	$61.58	$284.52
United Facility/Professional Professional Modifier Low / Median / High Price $45.83 / $91.48 / $141.61	Professional		$45.83	$91.48	$141.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.01 / $37.64 / $64.70	Professional	26	$22.01	$37.64	$64.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.82 / $55.54 / $83.26	Professional	TC	$23.82	$55.54	$83.26