Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.90 / $39.90 / $39.90	Facility	26	$39.90	$39.90	$39.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.37 / $210.27 / $355.50	Professional		$179.37	$210.27	$355.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.47 / $39.90 / $119.93	Professional	26	$21.47	$39.90	$119.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.57 / $174.43 / $238.66	Professional	TC	$144.57	$174.43	$238.66
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $30.81 / $30.81 / $30.81	Facility	26	$30.81	$30.81	$30.81
BCBS Facility/Professional Professional Modifier Low / Median / High Price $306.12 / $524.69 / $696.82	Professional		$306.12	$524.69	$696.82
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.11 / $98.93 / $131.38	Professional	26	$58.11	$98.93	$131.38
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $279.76 / $457.67 / $569.71	Professional	TC	$279.76	$457.67	$569.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.89 / $127.80 / $307.45	Facility	26	$81.89	$127.80	$307.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $253.81 / $548.80 / $854.61	Professional		$253.81	$548.80	$854.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.08 / $99.78 / $155.38	Professional	26	$39.08	$99.78	$155.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $224.44 / $449.03 / $699.23	Professional	TC	$224.44	$449.03	$699.23
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $70.95 / $116.63 / $242.09	Facility	26	$70.95	$116.63	$242.09
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $336.44 / $537.91 / $772.20	Professional		$336.44	$537.91	$772.20
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $61.17 / $97.10 / $140.40	Professional	26	$61.17	$97.10	$140.40
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $275.27 / $441.83 / $631.79	Professional	TC	$275.27	$441.83	$631.79
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $169.56 / $169.56 / $169.56	Facility	26	$169.56	$169.56	$169.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $231.44 / $419.52 / $1,546.49	Professional		$231.44	$419.52	$1,546.49
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $40.44 / $80.63 / $391.31	Professional	26	$40.44	$80.63	$391.31
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $189.98 / $345.42 / $1,417.87	Professional	TC	$189.98	$345.42	$1,417.87
United Facility/Professional Professional Modifier Low / Median / High Price $210.40 / $402.57 / $742.71	Professional		$210.40	$402.57	$742.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.24 / $75.90 / $145.22	Professional	26	$39.24	$75.90	$145.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $186.19 / $331.75 / $597.49	Professional	TC	$186.19	$331.75	$597.49