Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.50 / $200.50 / $200.50	Facility	26	$200.50	$200.50	$200.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.05 / $316.85 / $665.91	Professional		$288.05	$316.85	$665.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $171.18 / $196.59 / $308.37	Professional	26	$171.18	$196.59	$308.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.03 / $116.85 / $165.88	Professional	TC	$99.03	$116.85	$165.88
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $155.49 / $155.49 / $155.49	Facility	26	$155.49	$155.49	$155.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $415.07 / $777.42 / $1,001.83	Professional		$415.07	$777.42	$1,001.83
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $267.60 / $496.13 / $639.34	Professional	26	$267.60	$496.13	$639.34
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.00 / $293.45 / $362.49	Professional	TC	$151.00	$293.45	$362.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $453.98 / $643.79 / $1,548.75	Facility	26	$453.98	$643.79	$1,548.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $486.25 / $785.34 / $1,222.93	Professional		$486.25	$785.34	$1,222.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $310.06 / $500.77 / $779.80	Professional	26	$310.06	$500.77	$779.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $176.72 / $284.57 / $443.13	Professional	TC	$176.72	$284.57	$443.13
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $412.50 / $588.59 / $1,219.49	Facility	26	$412.50	$588.59	$1,219.49
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $481.44 / $731.00 / $1,105.00	Professional		$481.44	$731.00	$1,105.00
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $306.99 / $466.12 / $704.60	Professional	26	$306.99	$466.12	$704.60
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $174.45 / $264.88 / $400.40	Professional	TC	$174.45	$264.88	$400.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $350.03 / $663.85 / $1,551.63	Professional		$350.03	$663.85	$1,551.63
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $213.97 / $402.28 / $965.29	Professional	26	$213.97	$402.28	$965.29
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $128.87 / $239.23 / $684.55	Professional	TC	$128.87	$239.23	$684.55
United Facility/Professional Professional Modifier Low / Median / High Price $340.84 / $608.33 / $1,130.98	Professional		$340.84	$608.33	$1,130.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $211.37 / $402.28 / $703.60	Professional	26	$211.37	$402.28	$703.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $127.44 / $241.71 / $409.86	Professional	TC	$127.44	$241.71	$409.86