Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.22 / $49.22 / $49.22	Facility	26	$49.22	$49.22	$49.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $261.73 / $387.41	Professional		$206.63	$261.73	$387.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.69 / $49.22 / $70.01	Professional	26	$42.69	$49.22	$70.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $222.01 / $322.42	Professional	TC	$162.49	$222.01	$322.42
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.72 / $37.72 / $37.72	Facility	26	$37.72	$37.72	$37.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $398.47 / $723.01 / $965.46	Professional		$398.47	$723.01	$965.46
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $69.52 / $120.13 / $159.54	Professional	26	$69.52	$120.13	$159.54
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $377.74 / $644.74 / $812.01	Professional	TC	$377.74	$644.74	$812.01
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $102.55 / $160.05 / $385.03	Facility	26	$102.55	$160.05	$385.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $332.77 / $720.66 / $1,122.22	Professional		$332.77	$720.66	$1,122.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.87 / $121.96 / $189.91	Professional	26	$54.87	$121.96	$189.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $279.64 / $598.70 / $940.57	Professional	TC	$279.64	$598.70	$940.57
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $88.87 / $146.06 / $303.18	Facility	26	$88.87	$146.06	$303.18
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $441.79 / $711.20 / $1,014.00	Professional		$441.79	$711.20	$1,014.00
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $74.76 / $120.34 / $171.60	Professional	26	$74.76	$120.34	$171.60
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $367.03 / $590.85 / $842.40	Professional	TC	$367.03	$590.85	$842.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $202.83 / $202.83 / $202.83	Facility	26	$202.83	$202.83	$202.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $305.68 / $554.40 / $1,904.10	Professional		$305.68	$554.40	$1,904.10
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $49.72 / $95.49 / $588.72	Professional	26	$49.72	$95.49	$588.72
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $252.09 / $465.21 / $1,640.58	Professional	TC	$252.09	$465.21	$1,640.58
United Facility/Professional Professional Modifier Low / Median / High Price $291.01 / $544.66 / $980.95	Professional		$291.01	$544.66	$980.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.72 / $89.07 / $173.81	Professional	26	$48.72	$89.07	$173.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.55 / $445.86 / $847.11	Professional	TC	$235.55	$445.86	$847.11