Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $371.54 / $371.54	Facility		$177.83	$371.54	$371.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $177.83 / $177.83 / $177.83	Facility	26	$177.83	$177.83	$177.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $190.55 / $190.55 / $190.55	Facility	TC	$190.55	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $416.87 / $1,023.29	Professional		$331.13	$416.87	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $151.36 / $208.93 / $524.81	Professional	26	$151.36	$208.93	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $208.93 / $512.86	Professional	TC	$169.82	$208.93	$512.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Facility		$162.18	$162.18	$162.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $676.08 / $954.99 / $1,318.26	Professional		$676.08	$954.99	$1,318.26
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $316.23 / $436.52 / $616.60	Professional	26	$316.23	$436.52	$616.60
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $524.81 / $691.83	Professional	TC	$354.81	$524.81	$691.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $954.99 / $2,754.23 / $3,311.31	Facility		$954.99	$2,754.23	$3,311.31
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $446.68 / $1,288.25 / $1,548.82	Facility	26	$446.68	$1,288.25	$1,548.82
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $512.86 / $1,479.11 / $1,737.80	Facility	TC	$512.86	$1,479.11	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $436.52 / $524.81	Professional		$416.87	$436.52	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $204.17 / $245.47	Professional	26	$194.98	$204.17	$245.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $234.42 / $281.84	Professional	TC	$223.87	$234.42	$281.84
Health Partners Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $2,570.40 / $2,570.40	Facility		$870.96	$2,570.40	$2,570.40
Health Partners Facility/Professional Facility Modifier 26 Low / Median / High Price $407.38 / $1,202.26 / $1,202.26	Facility	26	$407.38	$1,202.26	$1,202.26
Health Partners Facility/Professional Facility Modifier TC Low / Median / High Price $457.09 / $1,380.38 / $1,380.38	Facility	TC	$457.09	$1,380.38	$1,380.38
Health Partners Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $416.87 / $1,258.93	Professional		$416.87	$416.87	$1,258.93
Health Partners Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $194.98 / $489.78	Professional	26	$194.98	$194.98	$489.78
Health Partners Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $891.25	Professional	TC	$223.87	$223.87	$891.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $575.44 / $776.25 / $1,148.15	Facility		$575.44	$776.25	$1,148.15
Medica Facility/Professional Facility Modifier 26 Low / Median / High Price $851.14 / $851.14 / $851.14	Facility	26	$851.14	$851.14	$851.14
Medica Facility/Professional Facility Modifier TC Low / Median / High Price $1,445.44 / $1,445.44 / $1,445.44	Facility	TC	$1,445.44	$1,445.44	$1,445.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $794.33 / $1,380.38	Professional		$346.74	$794.33	$1,380.38
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $186.21 / $512.86 / $3,019.95	Professional	26	$186.21	$512.86	$3,019.95
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $316.23 / $660.69	Professional	TC	$97.72	$316.23	$660.69
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $724.44 / $1,202.26	Professional		$346.74	$724.44	$1,202.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $346.74 / $575.44	Professional	26	$147.91	$346.74	$575.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $354.81 / $616.60	Professional	TC	$162.18	$354.81	$616.60