Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.50 / $48.50 / $48.50	Facility	26	$48.50	$48.50	$48.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $322.18 / $360.64 / $508.81	Professional		$322.18	$360.64	$508.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $166.87 / $205.30 / $254.41	Professional	52	$166.87	$205.30	$254.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $272.83 / $314.52 / $450.21	Professional	TC	$272.83	$314.52	$450.21
BCBS Facility/Professional Facility Modifier 26 Low / Median / High Price $37.43 / $37.43 / $37.43	Facility	26	$37.43	$37.43	$37.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $545.46 / $1,024.11 / $1,319.74	Professional		$545.46	$1,024.11	$1,319.74
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $492.00 / $941.92 / $1,163.72	Professional	TC	$492.00	$941.92	$1,163.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $110.34 / $156.47 / $376.41	Facility	26	$110.34	$156.47	$376.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $650.44 / $1,050.50 / $1,635.85	Professional		$650.44	$1,050.50	$1,635.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $575.50 / $929.47 / $1,447.37	Professional	TC	$575.50	$929.47	$1,447.37
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $100.25 / $142.79 / $296.39	Facility	26	$100.25	$142.79	$296.39
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $644.00 / $977.82 / $1,478.10	Professional		$644.00	$977.82	$1,478.10
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $569.79 / $865.16 / $1,307.80	Professional	TC	$569.79	$865.16	$1,307.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $392.23 / $716.22 / $2,332.00	Professional		$392.23	$716.22	$2,332.00
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $312.61 / $4,040.55 / $4,489.50	Professional	52	$312.61	$4,040.55	$4,489.50
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $339.82 / $631.47 / $2,048.28	Professional	TC	$339.82	$631.47	$2,048.28
United Facility/Professional Professional Modifier Low / Median / High Price $392.23 / $684.24 / $1,310.69	Professional		$392.23	$684.24	$1,310.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $339.82 / $642.57 / $1,139.91	Professional	TC	$339.82	$642.57	$1,139.91