Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $169.12 / $169.12 / $169.12	Facility	26	$169.12	$169.12	$169.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $248.78 / $274.87 / $932.72	Professional		$248.78	$274.87	$932.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.25 / $167.48 / $372.06	Professional	26	$144.25	$167.48	$372.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $91.42 / $107.39 / $152.46	Professional	TC	$91.42	$107.39	$152.46
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $131.02 / $131.02 / $131.02	Facility	26	$131.02	$131.02	$131.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.52 / $661.21 / $868.09	Professional		$354.52	$661.21	$868.09
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $225.60 / $419.66 / $540.79	Professional	26	$225.60	$419.66	$540.79
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $132.00 / $261.83 / $327.29	Professional	TC	$132.00	$261.83	$327.29
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $384.91 / $545.86 / $1,313.13	Facility	26	$384.91	$545.86	$1,313.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $415.32 / $670.77 / $1,044.52	Professional		$415.32	$670.77	$1,044.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $261.43 / $422.23 / $657.50	Professional	26	$261.43	$422.23	$657.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.35 / $248.54 / $387.02	Professional	TC	$154.35	$248.54	$387.02
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $349.74 / $498.13 / $1,033.96	Facility	26	$349.74	$498.13	$1,033.96
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $411.21 / $624.36 / $943.80	Professional		$411.21	$624.36	$943.80
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $258.83 / $393.02 / $594.10	Professional	26	$258.83	$393.02	$594.10
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $152.36 / $231.34 / $349.70	Professional	TC	$152.36	$231.34	$349.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $317.64 / $628.63 / $1,600.14	Professional		$317.64	$628.63	$1,600.14
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $180.24 / $338.82 / $982.86	Professional	26	$180.24	$338.82	$982.86
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $116.29 / $215.38 / $617.27	Professional	TC	$116.29	$215.38	$617.27
United Facility/Professional Professional Modifier Low / Median / High Price $294.97 / $525.57 / $977.18	Professional		$294.97	$525.57	$977.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $178.03 / $340.81 / $592.59	Professional	26	$178.03	$340.81	$592.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.73 / $205.16 / $383.67	Professional	TC	$114.73	$205.16	$383.67