Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.26 / $84.00 / $467.40	Facility		$51.26	$84.00	$467.40
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $62.02 / $167.10 / $531.22	Facility	25	$62.02	$167.10	$531.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.84 / $89.65 / $239.54	Professional		$52.84	$89.65	$239.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $52.43 / $97.93 / $257.00	Professional	25	$52.43	$97.93	$257.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.97 / $117.21 / $665.28	Facility		$57.97	$117.21	$665.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.24 / $176.73 / $246.16	Professional		$117.24	$176.73	$246.16
BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $93.90 / $141.38 / $196.93	Professional	25	$93.90	$141.38	$196.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.87 / $294.62 / $645.13	Facility		$205.87	$294.62	$645.13
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.26 / $212.20 / $336.68	Professional		$109.26	$212.20	$336.68
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $178.40 / $264.43 / $608.61	Facility		$178.40	$264.43	$608.61
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $121.92 / $200.45 / $302.02	Professional		$121.92	$200.45	$302.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.75 / $102.15 / $188.73	Facility		$52.75	$102.15	$188.73
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $150.96 / $238.08 / $433.05	Facility	25	$150.96	$238.08	$433.05
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $149.93 / $186.38 / $186.38	Facility	62	$149.93	$186.38	$186.38
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $23.99 / $29.82 / $29.82	Facility	AS	$23.99	$29.82	$29.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $136.68 / $217.62 / $282.62	Professional		$136.68	$217.62	$282.62
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $147.05 / $205.79 / $263.83	Professional	25	$147.05	$205.79	$263.83
United Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $145.72 / $245.29	Professional		$79.95	$145.72	$245.29