Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $128.61 / $128.61 / $217.35	Facility	26	$128.61	$128.61	$217.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $604.58 / $727.36 / $1,065.40	Professional		$604.58	$727.36	$1,065.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $113.37 / $136.76 / $540.90	Professional	26	$113.37	$136.76	$540.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $285.27 / $320.01 / $442.29	Professional	52	$285.27	$320.01	$442.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $482.54 / $574.95 / $842.47	Professional	TC	$482.54	$574.95	$842.47
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $98.47 / $98.47 / $98.47	Facility	26	$98.47	$98.47	$98.47
BCBS Facility/Professional Professional Modifier Low / Median / High Price $918.53 / $1,704.13 / $2,196.04	Professional		$918.53	$1,704.13	$2,196.04
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $169.45 / $315.89 / $407.07	Professional	26	$169.45	$315.89	$407.07
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $767.00 / $1,462.48 / $1,788.98	Professional	TC	$767.00	$1,462.48	$1,788.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $288.89 / $409.69 / $985.57	Facility	26	$288.89	$409.69	$985.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,309.57 / $1,398.39 / $1,663.16	Professional		$1,309.57	$1,398.39	$1,663.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $235.92 / $251.92 / $299.61	Professional	26	$235.92	$251.92	$299.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,073.66 / $1,146.47 / $1,363.54	Professional	TC	$1,073.66	$1,146.47	$1,363.54
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $262.50 / $373.87 / $776.04	Facility	26	$262.50	$373.87	$776.04
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $1,300.73 / $1,306.91 / $1,309.57	Professional		$1,300.73	$1,306.91	$1,309.57
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $235.44 / $235.44 / $235.92	Professional	26	$235.44	$235.44	$235.92
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $1,065.29 / $1,071.47 / $1,073.66	Professional	TC	$1,065.29	$1,071.47	$1,073.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $740.03 / $1,332.50 / $6,200.00	Professional		$740.03	$1,332.50	$6,200.00
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $155.63 / $289.77 / $2,600.00	Professional	26	$155.63	$289.77	$2,600.00
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $590.00 / $1,037.56 / $7,000.00	Professional	TC	$590.00	$1,037.56	$7,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $698.61 / $1,242.20 / $2,192.48	Professional		$698.61	$1,242.20	$2,192.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $136.96 / $234.51 / $439.52	Professional	26	$136.96	$234.51	$439.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $564.34 / $1,025.46 / $1,826.71	Professional	TC	$564.34	$1,025.46	$1,826.71