Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.34 / $40.34 / $40.34	Facility	26	$40.34	$40.34	$40.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.28 / $87.55 / $317.30	Professional		$61.28	$87.55	$317.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.72 / $41.88 / $196.20	Professional	26	$34.72	$41.88	$196.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.05 / $34.19 / $99.68	Professional	TC	$21.05	$34.19	$99.68
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.81 / $30.81 / $32.15	Facility	26	$30.81	$30.81	$32.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $174.80 / $275.68	Professional		$110.76	$174.80	$275.68
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $52.74 / $84.18 / $126.69	Professional	26	$52.74	$84.18	$126.69
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.55 / $103.42 / $148.97	Professional	TC	$60.55	$103.42	$148.97
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $90.92 / $129.00 / $310.32	Facility	26	$90.92	$129.00	$310.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $133.86 / $216.20 / $336.66	Professional		$133.86	$216.20	$336.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.78 / $99.78 / $155.38	Professional	26	$61.78	$99.78	$155.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $72.08 / $116.41 / $181.28	Professional	TC	$72.08	$116.41	$181.28
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $73.95 / $117.72 / $244.35	Facility	26	$73.95	$117.72	$244.35
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $197.47 / $304.20	Professional		$118.90	$197.47	$304.20
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $91.14 / $140.40	Professional	26	$54.87	$91.14	$140.40
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $64.02 / $106.33 / $163.80	Professional	TC	$64.02	$106.33	$163.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $174.72 / $174.72 / $174.72	Facility	26	$174.72	$174.72	$174.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.38 / $143.59 / $290.12	Professional		$76.38	$143.59	$290.12
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $77.81 / $147.35	Professional	26	$43.67	$77.81	$147.35
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $28.52 / $65.75 / $134.31	Professional	TC	$28.52	$65.75	$134.31
United Facility/Professional Professional Modifier Low / Median / High Price $76.38 / $143.59 / $266.67	Professional		$76.38	$143.59	$266.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.09 / $77.81 / $137.35	Professional	26	$47.09	$77.81	$137.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.52 / $65.78 / $123.45	Professional	TC	$28.52	$65.78	$123.45