Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $143.30 / $143.30 / $143.30	Facility		$143.30	$143.30	$143.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.79 / $23.79 / $23.79	Facility	26	$23.79	$23.79	$23.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $113.82 / $134.71 / $223.86	Professional		$113.82	$134.71	$223.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.77 / $22.12 / $32.56	Professional	26	$11.77	$22.12	$32.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.88 / $109.01 / $189.87	Professional	TC	$92.88	$109.01	$189.87
BCBS Facility/Professional Facility Modifier Low / Median / High Price $196.91 / $264.91 / $264.91	Facility		$196.91	$264.91	$264.91
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $41.51 / $41.51 / $41.51	Facility	26	$41.51	$41.51	$41.51
BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.17 / $426.55 / $517.34	Professional		$225.17	$426.55	$517.34
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $35.28 / $66.73 / $80.94	Professional	26	$35.28	$66.73	$80.94
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $218.06 / $359.80 / $436.39	Professional	TC	$218.06	$359.80	$436.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $304.86 / $447.52 / $1,270.03	Facility		$304.86	$447.52	$1,270.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.45 / $63.79 / $181.02	Facility	26	$43.45	$63.79	$181.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $225.38 / $402.83 / $627.29	Professional		$225.38	$402.83	$627.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.03 / $57.53 / $90.64	Professional	26	$31.03	$57.53	$90.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $195.60 / $344.62 / $536.65	Professional	TC	$195.60	$344.62	$536.65
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $263.33 / $419.06 / $1,000.03	Facility		$263.33	$419.06	$1,000.03
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $37.54 / $59.73 / $142.54	Facility	26	$37.54	$59.73	$142.54
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $258.77 / $385.90 / $566.79	Professional		$258.77	$385.90	$566.79
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $37.39 / $55.76 / $81.90	Professional	26	$37.39	$55.76	$81.90
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $221.38 / $330.14 / $484.90	Professional	TC	$221.38	$330.14	$484.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.88 / $219.10 / $388.99	Facility		$128.88	$219.10	$388.99
Medica Facility/Professional Professional Modifier Low / Median / High Price $163.18 / $310.52 / $1,197.25	Professional		$163.18	$310.52	$1,197.25
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $22.29 / $47.42 / $198.13	Professional	26	$22.29	$47.42	$198.13
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $136.79 / $263.17 / $1,126.14	Professional	TC	$136.79	$263.17	$1,126.14
United Facility/Professional Professional Modifier Low / Median / High Price $156.74 / $283.05 / $552.89	Professional		$156.74	$283.05	$552.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.28 / $43.55 / $86.34	Professional	26	$22.28	$43.55	$86.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.68 / $242.27 / $452.46	Professional	TC	$131.68	$242.27	$452.46