Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.12 / $87.12 / $87.12	Facility	26	$87.12	$87.12	$87.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.99 / $173.70 / $332.77	Professional		$131.99	$173.70	$332.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.70 / $85.60 / $124.46	Professional	26	$74.70	$85.60	$124.46
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $84.99 / $129.97	Professional	TC	$55.03	$84.99	$129.97
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $67.38 / $67.38 / $67.38	Facility	26	$67.38	$67.38	$67.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $225.60 / $426.16 / $560.74	Professional		$225.60	$426.16	$560.74
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.73 / $212.66 / $279.20	Professional	26	$115.73	$212.66	$279.20
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $111.25 / $225.23 / $281.54	Professional	TC	$111.25	$225.23	$281.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $197.93 / $280.69 / $675.24	Facility	26	$197.93	$280.69	$675.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.01 / $429.63 / $669.01	Professional		$266.01	$429.63	$669.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $134.44 / $217.12 / $338.10	Professional	26	$134.44	$217.12	$338.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.57 / $212.50 / $330.91	Professional	TC	$131.57	$212.50	$330.91
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $179.85 / $256.14 / $531.69	Facility	26	$179.85	$256.14	$531.69
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $263.38 / $399.90 / $604.50	Professional		$263.38	$399.90	$604.50
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $133.10 / $202.10 / $305.50	Professional	26	$133.10	$202.10	$305.50
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $130.27 / $197.80 / $299.00	Professional	TC	$130.27	$197.80	$299.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $193.34 / $364.77 / $1,053.48	Professional		$193.34	$364.77	$1,053.48
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $93.69 / $177.15 / $509.36	Professional	26	$93.69	$177.15	$509.36
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $99.65 / $188.43 / $544.05	Professional	TC	$99.65	$188.43	$544.05
United Facility/Professional Professional Modifier Low / Median / High Price $192.45 / $362.94 / $614.50	Professional		$192.45	$362.94	$614.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.56 / $169.06 / $300.64	Professional	26	$91.56	$169.06	$300.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $99.65 / $177.56 / $333.23	Professional	TC	$99.65	$177.56	$333.23