Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.48 / $77.48 / $118.80	Facility	26	$77.48	$77.48	$118.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.39 / $371.25 / $522.50	Professional		$202.39	$371.25	$522.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.34 / $111.15 / $154.00	Professional	26	$68.34	$111.15	$154.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.04 / $254.41 / $348.53	Professional	TC	$134.04	$254.41	$348.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $215.14 / $304.02 / $760.06	Professional		$215.14	$304.02	$760.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $78.81 / $108.18 / $154.53	Professional	26	$78.81	$108.18	$154.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.74 / $206.66 / $566.50	Professional	TC	$143.74	$206.66	$566.50
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $152.41 / $152.41 / $152.41	Facility	26	$152.41	$152.41	$152.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.11 / $323.89 / $585.63	Professional		$210.11	$323.89	$585.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.91 / $94.54 / $168.85	Professional	26	$67.91	$94.54	$168.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $223.75 / $401.04	Professional	TC	$142.13	$223.75	$401.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $290.58 / $368.81 / $700.00	Professional		$290.58	$368.81	$700.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.94 / $119.56 / $278.67	Professional	26	$95.94	$119.56	$278.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $194.64 / $242.55 / $582.76	Professional	TC	$194.64	$242.55	$582.76
United Facility/Professional Professional Modifier Low / Median / High Price $325.68 / $505.91 / $1,047.58	Professional		$325.68	$505.91	$1,047.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.51 / $134.21 / $217.15	Professional	26	$70.51	$134.21	$217.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.26 / $347.18 / $824.84	Professional	TC	$221.26	$347.18	$824.84