Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.06 / $66.06 / $66.06	Facility	26	$66.06	$66.06	$66.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $113.54 / $417.93	Professional		$93.18	$113.54	$417.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.10 / $68.94 / $166.44	Professional	26	$58.10	$68.94	$166.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.48 / $39.58 / $89.07	Professional	TC	$28.48	$39.58	$89.07
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $50.39 / $50.39 / $52.58	Facility	26	$50.39	$50.39	$52.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $235.77 / $368.35	Professional		$148.94	$235.77	$368.35
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $86.92 / $136.91 / $207.64	Professional	26	$86.92	$136.91	$207.64
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $65.43 / $110.85 / $160.71	Professional	TC	$65.43	$110.85	$160.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $147.32 / $209.03 / $502.84	Facility	26	$147.32	$209.03	$502.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $178.48 / $288.26 / $448.89	Professional		$178.48	$288.26	$448.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.68 / $162.61 / $253.22	Professional	26	$100.68	$162.61	$253.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.80 / $125.65 / $195.67	Professional	TC	$77.80	$125.65	$195.67
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $119.82 / $190.75 / $395.94	Facility	26	$119.82	$190.75	$395.94
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $158.53 / $263.30 / $405.60	Professional		$158.53	$263.30	$405.60
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $89.43 / $148.53 / $228.80	Professional	26	$89.43	$148.53	$228.80
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $69.09 / $114.77 / $176.80	Professional	TC	$69.09	$114.77	$176.80
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $284.70 / $284.70 / $284.70	Facility	26	$284.70	$284.70	$284.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $111.55 / $198.76 / $376.40	Professional		$111.55	$198.76	$376.40
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $71.45 / $126.86 / $241.11	Professional	26	$71.45	$126.86	$241.11
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $36.45 / $71.44 / $145.93	Professional	TC	$36.45	$71.44	$145.93
United Facility/Professional Professional Modifier Low / Median / High Price $109.40 / $203.03 / $368.45	Professional		$109.40	$203.03	$368.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $76.01 / $127.32 / $234.31	Professional	26	$76.01	$127.32	$234.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.54 / $71.44 / $134.08	Professional	TC	$37.54	$71.44	$134.08