Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $46.44 / $90.25	Facility	26	$37.15	$46.44	$90.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.90 / $138.38 / $227.37	Professional		$118.90	$138.38	$227.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.71 / $38.90 / $125.38	Professional	26	$32.71	$38.90	$125.38
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.90 / $50.78 / $50.78	Professional	52	$45.90	$50.78	$50.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.86 / $98.99 / $161.76	Professional	TC	$81.86	$98.99	$161.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.56 / $188.44 / $272.00	Professional		$135.56	$188.44	$272.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $51.72 / $73.88	Professional	26	$36.95	$51.72	$73.88
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.97 / $137.09 / $197.23	Professional	TC	$97.97	$137.09	$197.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.78 / $171.26 / $287.01	Professional		$119.78	$171.26	$287.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.46 / $46.46 / $79.43	Professional	26	$32.46	$46.46	$79.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $87.32 / $122.80 / $205.78	Professional	TC	$87.32	$122.80	$205.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $168.56 / $210.05 / $285.25	Professional		$168.56	$210.05	$285.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.01 / $57.33 / $77.86	Professional	26	$46.01	$57.33	$77.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $122.56 / $152.72 / $207.42	Professional	TC	$122.56	$152.72	$207.42
United Facility/Professional Professional Modifier Low / Median / High Price $151.99 / $222.89 / $346.68	Professional		$151.99	$222.89	$346.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $63.01 / $97.50	Professional	26	$41.66	$63.01	$97.50
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.83 / $156.81 / $238.45	Professional	TC	$104.83	$156.81	$238.45