Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $29.51	Facility	26	$19.05	$19.05	$29.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $87.10 / $398.11	Professional		$53.70	$87.10	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $22.91 / $112.20	Professional	26	$16.22	$22.91	$112.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $28.84 / $28.84 / $263.03	Professional	50	$28.84	$28.84	$263.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $44.67 / $85.11	Professional	TC	$36.31	$44.67	$85.11
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $13.80 / $15.85 / $15.85	Facility	26	$13.80	$15.85	$15.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $213.80	Professional		$85.11	$141.25	$213.80
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $42.66 / $64.57	Professional	26	$25.70	$42.66	$64.57
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $104.71 / $151.36	Professional	TC	$61.66	$104.71	$151.36
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.42 / $63.10 / $158.49	Facility	26	$20.42	$63.10	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $165.96 / $263.03	Professional		$91.20	$165.96	$263.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $47.86 / $75.86	Professional	26	$28.18	$47.86	$75.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $117.49 / $186.21	Professional	TC	$64.57	$117.49	$186.21
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $63.10 / $125.89	Facility	26	$51.29	$63.10	$125.89
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $154.88 / $239.88	Professional		$107.15	$154.88	$239.88
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $44.67 / $69.18	Professional	26	$31.62	$44.67	$69.18
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $109.65 / $169.82	Professional	TC	$75.86	$109.65	$169.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $165.96 / $331.13	Professional		$66.07	$165.96	$331.13
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $40.74 / $114.82	Professional	26	$19.50	$40.74	$114.82
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $81.28 / $302.00	Professional	TC	$44.67	$81.28	$302.00
United Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $117.49 / $218.78	Professional		$64.57	$117.49	$218.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $35.48 / $64.57	Professional	26	$19.50	$35.48	$64.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $83.18 / $154.88	Professional	TC	$44.67	$83.18	$154.88