Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.83 / $23.83 / $23.83	Facility	26	$23.83	$23.83	$23.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.56 / $36.86 / $149.28	Professional		$31.56	$36.86	$149.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.69 / $23.85 / $100.00	Professional	26	$20.69	$23.85	$100.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.67 / $17.42 / $23.08	Professional	52	$14.67	$17.42	$23.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.55 / $12.38 / $23.52	Professional	TC	$10.55	$12.38	$23.52
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $18.14 / $18.14 / $18.92	Facility	26	$18.14	$18.14	$18.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.17 / $89.66 / $119.66	Professional		$49.17	$89.66	$119.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $32.92 / $59.17 / $76.25	Professional	26	$32.92	$59.17	$76.25
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.32 / $34.40 / $43.40	Professional	TC	$20.32	$34.40	$43.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $76.44 / $183.90	Facility	26	$48.98	$76.44	$183.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $94.24 / $146.75	Professional		$57.77	$94.24	$146.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.25 / $59.13 / $92.08	Professional	26	$36.25	$59.13	$92.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.59 / $35.11 / $54.67	Professional	TC	$20.59	$35.11	$54.67
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $42.44 / $69.76 / $144.80	Facility	26	$42.44	$69.76	$144.80
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $88.73 / $132.60	Professional		$57.77	$88.73	$132.60
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $36.25 / $55.67 / $83.20	Professional	26	$36.25	$55.67	$83.20
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $21.52 / $33.06 / $49.40	Professional	TC	$21.52	$33.06	$49.40
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $98.42 / $98.42 / $98.42	Facility	26	$98.42	$98.42	$98.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $83.36 / $209.51	Professional		$37.72	$83.36	$209.51
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $24.63 / $46.81 / $138.46	Professional	26	$24.63	$46.81	$138.46
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $11.37 / $22.20 / $71.05	Professional	TC	$11.37	$22.20	$71.05
United Facility/Professional Professional Modifier Low / Median / High Price $34.97 / $61.05 / $116.82	Professional		$34.97	$61.05	$116.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.85 / $42.44 / $79.92	Professional	26	$23.85	$42.44	$79.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $10.91 / $20.88 / $38.22	Professional	TC	$10.91	$20.88	$38.22