Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $103.83 / $103.83 / $131.15	Facility	26	$103.83	$103.83	$131.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $339.81 / $378.75 / $654.36	Professional		$339.81	$378.75	$654.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.83 / $111.28 / $157.30	Professional	26	$103.83	$111.28	$157.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $150.02 / $150.02 / $170.00	Professional	52	$150.02	$150.02	$170.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.43 / $251.35 / $410.83	Professional	TC	$229.43	$251.35	$410.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $424.68 / $557.24 / $768.62	Professional		$424.68	$557.24	$768.62
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.22 / $149.87 / $206.72	Professional	26	$114.22	$149.87	$206.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $310.45 / $407.37 / $561.89	Professional	TC	$310.45	$407.37	$561.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $350.83 / $521.00 / $702.91	Professional		$350.83	$521.00	$702.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $123.99 / $153.47 / $207.89	Professional	26	$123.99	$153.47	$207.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.46 / $368.69 / $492.16	Professional	TC	$222.46	$368.69	$492.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.91 / $530.25 / $676.23	Professional		$426.91	$530.25	$676.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $124.80 / $153.75 / $197.68	Professional	26	$124.80	$153.75	$197.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $302.11 / $381.87 / $478.55	Professional	TC	$302.11	$381.87	$478.55
United Facility/Professional Professional Modifier Low / Median / High Price $368.92 / $559.40 / $860.01	Professional		$368.92	$559.40	$860.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $114.76 / $168.94 / $316.07	Professional	26	$114.76	$168.94	$316.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $242.40 / $381.55 / $600.29	Professional	TC	$242.40	$381.55	$600.29