Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.44 / $74.44 / $74.44	Facility		$74.44	$74.44	$74.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.01 / $20.01 / $20.01	Facility	26	$20.01	$20.01	$20.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.39 / $88.09 / $166.05	Professional		$62.39	$88.09	$166.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.72 / $19.59 / $25.67	Professional	26	$16.72	$19.59	$25.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.56 / $61.38 / $134.71	Professional	TC	$43.56	$61.38	$134.71
BCBS Facility/Professional Facility Modifier Low / Median / High Price $148.36 / $496.07 / $1,115.45	Facility		$148.36	$496.07	$1,115.45
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 $96.69 / $183.76 / $236.97	Professional		$96.69	$183.76	$236.97
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $26.37 / $49.12 / $63.35	Professional	26	$26.37	$49.12	$63.35
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $72.00 / $140.53 / $173.62	Professional	TC	$72.00	$140.53	$173.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $171.82 / $243.66 / $586.16	Facility		$171.82	$243.66	$586.16
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 $118.57 / $184.79 / $287.75	Professional		$118.57	$184.79	$287.75
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 $87.98 / $135.82 / $211.49	Professional	TC	$87.98	$135.82	$211.49
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $156.12 / $222.77 / $461.55	Facility		$156.12	$222.77	$461.55
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 $113.28 / $172.00 / $260.00	Professional		$113.28	$172.00	$260.00
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 $83.26 / $126.42 / $191.10	Professional	TC	$83.26	$126.42	$191.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $120.07 / $197.98	Facility		$69.73	$120.07	$197.98
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.17 / $185.54 / $803.55	Professional		$86.17	$185.54	$803.55
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $21.05 / $39.69 / $416.07	Professional	26	$21.05	$39.69	$416.07
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $64.53 / $143.24 / $567.25	Professional	TC	$64.53	$143.24	$567.25
United Facility/Professional Professional Modifier Low / Median / High Price $86.17 / $172.13 / $251.81	Professional		$86.17	$172.13	$251.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.78 / $39.50 / $67.53	Professional	26	$20.78	$39.50	$67.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.57 / $132.65 / $208.40	Professional	TC	$61.57	$132.65	$208.40