Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $294.19 / $294.19 / $294.19	Facility	26	$294.19	$294.19	$294.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,012.82 / $1,151.59 / $1,978.47	Professional		$1,012.82	$1,151.59	$1,978.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $268.74 / $383.33 / $1,352.00	Professional	26	$268.74	$383.33	$1,352.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $728.19 / $857.41 / $1,182.10	Professional	TC	$728.19	$857.41	$1,182.10
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $226.62 / $226.62 / $226.62	Facility	26	$226.62	$226.62	$226.62
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,453.73 / $2,412.48 / $3,745.65	Professional		$1,453.73	$2,412.48	$3,745.65
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $418.98 / $678.90 / $1,046.00	Professional	26	$418.98	$678.90	$1,046.00
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,034.75 / $1,806.91 / $2,911.58	Professional	TC	$1,034.75	$1,806.91	$2,911.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $664.55 / $942.41 / $2,267.09	Facility	26	$664.55	$942.41	$2,267.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $2,011.53 / $3,235.55 / $4,257.22	Professional		$2,011.53	$3,235.55	$4,257.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $530.91 / $862.84 / $1,154.59	Professional	26	$530.91	$862.84	$1,154.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,457.69 / $2,368.98 / $3,170.03	Professional	TC	$1,457.69	$2,368.98	$3,170.03
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $540.23 / $861.59 / $1,785.11	Facility	26	$540.23	$861.59	$1,785.11
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $1,770.96 / $2,788.67 / $3,846.70	Professional		$1,770.96	$2,788.67	$3,846.70
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $448.80 / $708.54 / $1,027.00	Professional	26	$448.80	$708.54	$1,027.00
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $1,232.21 / $1,977.69 / $2,819.70	Professional	TC	$1,232.21	$1,977.69	$2,819.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,313.56 / $2,325.37 / $4,006.18	Professional		$1,313.56	$2,325.37	$4,006.18
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $370.58 / $625.42 / $1,127.70	Professional	26	$370.58	$625.42	$1,127.70
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $942.98 / $1,694.75 / $2,900.69	Professional	TC	$942.98	$1,694.75	$2,900.69
United Facility/Professional Professional Modifier Low / Median / High Price $1,313.56 / $2,252.98 / $3,764.36	Professional		$1,313.56	$2,252.98	$3,764.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $409.12 / $714.12 / $1,059.63	Professional	26	$409.12	$714.12	$1,059.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $942.98 / $1,545.56 / $2,791.49	Professional	TC	$942.98	$1,545.56	$2,791.49