Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.63 / $19.63 / $19.63	Facility	26	$19.63	$19.63	$19.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.48 / $84.04 / $615.60	Professional		$59.48	$84.04	$615.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $18.94 / $45.59	Professional	26	$16.72	$18.94	$45.59
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.74 / $33.52 / $46.31	Professional	52	$29.74	$33.52	$46.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $44.92 / $68.73	Professional	TC	$38.11	$44.92	$68.73
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $15.26 / $15.26 / $15.26	Facility	26	$15.26	$15.26	$15.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.45 / $163.69 / $217.02	Professional		$85.45	$163.69	$217.02
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.37 / $48.15 / $63.35	Professional	26	$26.37	$48.15	$63.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $62.43 / $122.94 / $153.68	Professional	TC	$62.43	$122.94	$153.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.64 / $63.31 / $152.29	Facility	26	$44.64	$63.31	$152.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $167.23 / $260.41	Professional		$103.54	$167.23	$260.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.32 / $48.97 / $76.25	Professional	26	$30.32	$48.97	$76.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $73.22 / $118.26 / $184.16	Professional	TC	$73.22	$118.26	$184.16
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $40.56 / $57.77 / $119.91	Facility	26	$40.56	$57.77	$119.91
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $102.52 / $155.66 / $235.30	Professional		$102.52	$155.66	$235.30
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $30.02 / $45.58 / $68.90	Professional	26	$30.02	$45.58	$68.90
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $72.50 / $110.08 / $166.40	Professional	TC	$72.50	$110.08	$166.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $167.74 / $322.66	Professional		$74.84	$167.74	$322.66
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.92 / $40.88 / $115.58	Professional	26	$21.92	$40.88	$115.58
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $49.23 / $90.58 / $299.48	Professional	TC	$49.23	$90.58	$299.48
United Facility/Professional Professional Modifier Low / Median / High Price $70.27 / $128.66 / $234.98	Professional		$70.27	$128.66	$234.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.90 / $37.49 / $69.43	Professional	26	$20.90	$37.49	$69.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.09 / $89.50 / $164.61	Professional	TC	$46.09	$89.50	$164.61