Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $92.00 / $92.00 / $92.00	Facility	26	$92.00	$92.00	$92.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $365.98 / $428.43 / $715.90	Professional		$365.98	$428.43	$715.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.06 / $92.00 / $230.02	Professional	26	$81.06	$92.00	$230.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $284.67 / $339.55 / $483.35	Professional	TC	$284.67	$339.55	$483.35
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $71.40 / $71.40 / $71.40	Facility	26	$71.40	$71.40	$71.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $648.98 / $1,210.73 / $1,560.22	Professional		$648.98	$1,210.73	$1,560.22
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $122.57 / $229.40 / $295.62	Professional	26	$122.57	$229.40	$295.62
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $539.00 / $1,031.38 / $1,264.59	Professional	TC	$539.00	$1,031.38	$1,264.59
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $209.72 / $297.41 / $715.47	Facility	26	$209.72	$297.41	$715.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $772.86 / $1,248.22 / $1,943.74	Professional		$772.86	$1,248.22	$1,943.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $142.44 / $230.06 / $358.25	Professional	26	$142.44	$230.06	$358.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $630.41 / $1,018.17 / $1,585.49	Professional	TC	$630.41	$1,018.17	$1,585.49
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $190.56 / $271.41 / $563.36	Facility	26	$190.56	$271.41	$563.36
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $765.21 / $1,161.85 / $1,756.30	Professional		$765.21	$1,161.85	$1,756.30
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $141.03 / $214.14 / $323.70	Professional	26	$141.03	$214.14	$323.70
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $624.16 / $947.72 / $1,432.60	Professional	TC	$624.16	$947.72	$1,432.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $458.51 / $943.85 / $2,747.80	Professional		$458.51	$943.85	$2,747.80
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $98.85 / $186.91 / $774.69	Professional	26	$98.85	$186.91	$774.69
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $359.66 / $681.66 / $2,208.88	Professional	TC	$359.66	$681.66	$2,208.88
United Facility/Professional Professional Modifier Low / Median / High Price $458.23 / $816.99 / $1,530.10	Professional		$458.23	$816.99	$1,530.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $98.85 / $186.91 / $323.32	Professional	26	$98.85	$186.91	$323.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $359.66 / $648.62 / $1,206.78	Professional	TC	$359.66	$648.62	$1,206.78