Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $109.78 / $109.78 / $109.78	Facility	26	$109.78	$109.78	$109.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.25 / $428.20 / $837.07	Professional		$393.25	$428.20	$837.07
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.71 / $109.78 / $231.29	Professional	26	$90.71	$109.78	$231.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $302.52 / $323.22 / $515.44	Professional	TC	$302.52	$323.22	$515.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $440.84 / $605.83 / $971.83	Professional		$440.84	$605.83	$971.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $108.66 / $149.33 / $239.55	Professional	26	$108.66	$149.33	$239.55
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $334.98 / $456.49 / $732.27	Professional	TC	$334.98	$456.49	$732.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $425.82 / $620.41 / $900.38	Professional		$425.82	$620.41	$900.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $101.39 / $152.75 / $213.70	Professional	26	$101.39	$152.75	$213.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $328.12 / $467.65 / $690.74	Professional	TC	$328.12	$467.65	$690.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $428.20 / $644.34 / $807.46	Professional		$428.20	$644.34	$807.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.78 / $165.19 / $207.01	Professional	26	$109.78	$165.19	$207.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $318.42 / $479.15 / $604.30	Professional	TC	$318.42	$479.15	$604.30
United Facility/Professional Professional Modifier Low / Median / High Price $544.15 / $755.81 / $1,152.15	Professional		$544.15	$755.81	$1,152.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $130.74 / $174.96 / $273.38	Professional	26	$130.74	$174.96	$273.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $413.41 / $562.41 / $878.77	Professional	TC	$413.41	$562.41	$878.77