Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.22 / $39.22 / $94.05	Facility	26	$39.22	$39.22	$94.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.16 / $135.07 / $243.40	Professional		$54.16	$135.07	$243.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.56 / $39.63 / $79.20	Professional	26	$34.56	$39.63	$79.20
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $283.00 / $283.00 / $283.00	Professional	52	$283.00	$283.00	$283.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.69 / $94.39 / $151.87	Professional	TC	$75.69	$94.39	$151.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.69 / $183.72 / $264.33	Professional		$131.69	$183.72	$264.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $39.10 / $54.56 / $77.94	Professional	26	$39.10	$54.56	$77.94
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $92.37 / $129.55 / $186.39	Professional	TC	$92.37	$129.55	$186.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.18 / $167.19 / $280.89	Professional		$117.18	$167.19	$280.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.60 / $50.90 / $85.92	Professional	26	$34.60	$50.90	$85.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.58 / $116.83 / $194.65	Professional	TC	$82.58	$116.83	$194.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $164.83 / $205.40 / $278.94	Professional		$164.83	$205.40	$278.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $48.57 / $60.52 / $82.19	Professional	26	$48.57	$60.52	$82.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $116.26 / $144.88 / $196.75	Professional	TC	$116.26	$144.88	$196.75
United Facility/Professional Professional Modifier Low / Median / High Price $148.08 / $223.73 / $341.05	Professional		$148.08	$223.73	$341.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.71 / $67.27 / $99.75	Professional	26	$43.71	$67.27	$99.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.37 / $156.97 / $236.40	Professional	TC	$104.37	$156.97	$236.40