Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.57 / $49.57 / $49.57	Facility	26	$49.57	$49.57	$49.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.11 / $102.96 / $143.88	Professional		$93.11	$102.96	$143.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.93 / $55.04 / $75.97	Professional	TC	$48.93	$55.04	$75.97
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.72 / $37.72 / $37.72	Facility	26	$37.72	$37.72	$37.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.90 / $253.20 / $333.16	Professional		$129.90	$253.20	$333.16
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.22 / $139.83 / $174.79	Professional	TC	$67.22	$139.83	$174.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.86 / $160.05 / $385.03	Facility	26	$112.86	$160.05	$385.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $152.16 / $245.76 / $383.74	Professional		$152.16	$245.76	$383.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.66 / $123.81 / $198.33	Professional	TC	$76.66	$123.81	$198.33
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $102.55 / $146.33 / $303.18	Facility	26	$102.55	$146.33	$303.18
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $150.66 / $228.76 / $345.80	Professional		$150.66	$228.76	$345.80
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $75.90 / $115.24 / $174.20	Professional	TC	$75.90	$115.24	$174.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $208.09 / $646.83	Professional		$110.76	$208.09	$646.83
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $55.98 / $105.85 / $354.71	Professional	TC	$55.98	$105.85	$354.71
United Facility/Professional Professional Modifier Low / Median / High Price $111.57 / $208.09 / $365.38	Professional		$111.57	$208.09	$365.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.91 / $103.64 / $186.77	Professional	TC	$54.91	$103.64	$186.77