Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.41 / $131.41 / $131.41	Facility		$131.41	$131.41	$131.41
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.44 / $24.44 / $24.44	Facility	26	$24.44	$24.44	$24.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.79 / $130.57 / $209.68	Professional		$105.79	$130.57	$209.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $24.44 / $34.52	Professional	26	$20.50	$24.44	$34.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.64 / $106.95 / $155.07	Professional	TC	$87.64	$106.95	$155.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $142.29 / $299.39 / $648.22	Facility		$142.29	$299.39	$648.22
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $18.71 / $18.71 / $18.71	Facility	26	$18.71	$18.71	$18.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.08 / $312.69 / $415.28	Professional		$181.08	$312.69	$415.28
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.79 / $61.84 / $82.12	Professional	26	$35.79	$61.84	$82.12
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $164.84 / $269.66 / $335.68	Professional	TC	$164.84	$269.66	$335.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $271.68 / $424.02 / $1,020.05	Facility		$271.68	$424.02	$1,020.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.51 / $78.83 / $189.64	Facility	26	$50.51	$78.83	$189.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.47 / $324.30 / $505.00	Professional		$160.47	$324.30	$505.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.48 / $60.98 / $94.96	Professional	26	$26.48	$60.98	$94.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.76 / $263.32 / $410.04	Professional	TC	$135.76	$263.32	$410.04
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $235.44 / $373.85 / $803.19	Facility		$235.44	$373.85	$803.19
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $43.77 / $69.50 / $149.33	Facility	26	$43.77	$69.50	$149.33
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $198.81 / $318.80 / $456.30	Professional		$198.81	$318.80	$456.30
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $59.34 / $85.80	Professional	26	$37.38	$59.34	$85.80
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $161.41 / $259.52 / $370.50	Professional	TC	$161.41	$259.52	$370.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $122.09 / $208.09 / $354.53	Facility		$122.09	$208.09	$354.53
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $104.46 / $104.46 / $104.46	Facility	26	$104.46	$104.46	$104.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $135.77 / $249.34 / $1,013.21	Professional		$135.77	$249.34	$1,013.21
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $26.13 / $49.51 / $217.94	Professional	26	$26.13	$49.51	$217.94
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $107.98 / $204.19 / $889.85	Professional	TC	$107.98	$204.19	$889.85
United Facility/Professional Professional Modifier Low / Median / High Price $133.79 / $237.88 / $449.44	Professional		$133.79	$237.88	$449.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.26 / $44.91 / $87.58	Professional	26	$25.26	$44.91	$87.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $103.08 / $192.41 / $361.12	Professional	TC	$103.08	$192.41	$361.12