Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.85 / $12.85 / $19.27	Facility	26	$12.85	$12.85	$19.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.84 / $58.97 / $261.00	Professional		$51.84	$58.97	$261.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.17 / $13.41 / $58.00	Professional	26	$11.17	$13.41	$58.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.04 / $27.99 / $36.45	Professional	52	$23.04	$27.99	$36.45
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.22 / $44.17 / $84.25	Professional	TC	$39.22	$44.17	$84.25
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $9.78 / $9.78 / $10.21	Facility	26	$9.78	$9.78	$10.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $148.66 / $197.08	Professional		$84.90	$148.66	$197.08
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $30.97 / $41.06	Professional	26	$17.48	$30.97	$41.06
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.23 / $123.66 / $156.02	Professional	TC	$72.23	$123.66	$156.02
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.02 / $40.61 / $97.69	Facility	26	$26.02	$40.61	$97.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.94 / $157.99 / $246.02	Professional		$95.94	$157.99	$246.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.30 / $31.41 / $48.92	Professional	26	$19.30	$31.41	$48.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.00 / $126.58 / $197.11	Professional	TC	$75.00	$126.58	$197.11
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $22.55 / $37.06 / $76.93	Facility	26	$22.55	$37.06	$76.93
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $96.85 / $148.75 / $222.30	Professional		$96.85	$148.75	$222.30
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $19.26 / $29.58 / $44.20	Professional	26	$19.26	$29.58	$44.20
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $77.59 / $119.18 / $178.10	Professional	TC	$77.59	$119.18	$178.10
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $80.00 / $80.00 / $80.00	Facility	26	$80.00	$80.00	$80.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.95 / $156.61 / $280.86	Professional		$59.95	$156.61	$280.86
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $14.84 / $33.32 / $50.04	Professional	26	$14.84	$33.32	$50.04
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $43.13 / $82.07 / $191.82	Professional	TC	$43.13	$82.07	$191.82
United Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $102.03 / $191.58	Professional		$56.24	$102.03	$191.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.01 / $23.37 / $43.03	Professional	26	$13.01	$23.37	$43.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.87 / $77.45 / $145.91	Professional	TC	$41.87	$77.45	$145.91