Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $439.74 / $439.74 / $643.99	Facility	26	$439.74	$439.74	$643.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,889.42 / $2,114.63 / $4,748.49	Professional		$1,889.42	$2,114.63	$4,748.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $347.37 / $439.74 / $1,003.14	Professional	26	$347.37	$439.74	$1,003.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $1,530.44 / $1,745.82 / $2,474.75	Professional	TC	$1,530.44	$1,745.82	$2,474.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,976.02 / $2,692.80 / $4,319.58	Professional		$1,976.02	$2,692.80	$4,319.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $438.00 / $592.57 / $957.47	Professional	26	$438.00	$592.57	$957.47
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $1,525.11 / $2,095.92 / $3,362.10	Professional	TC	$1,525.11	$2,095.92	$3,362.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,807.05 / $2,864.50 / $4,064.57	Professional		$1,807.05	$2,864.50	$4,064.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $397.74 / $611.29 / $850.56	Professional	26	$397.74	$611.29	$850.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1,408.71 / $2,240.29 / $3,052.21	Professional	TC	$1,408.71	$2,240.29	$3,052.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,970.18 / $2,964.65 / $3,715.19	Professional		$1,970.18	$2,964.65	$3,715.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $439.74 / $661.70 / $829.22	Professional	26	$439.74	$661.70	$829.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $1,530.44 / $2,302.94 / $2,885.97	Professional	TC	$1,530.44	$2,302.94	$2,885.97
United Facility/Professional Professional Modifier Low / Median / High Price $2,506.34 / $3,132.58 / $4,873.00	Professional		$2,506.34	$3,132.58	$4,873.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $475.12 / $692.34 / $1,081.78	Professional	26	$475.12	$692.34	$1,081.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $2,016.93 / $2,521.21 / $4,274.60	Professional	TC	$2,016.93	$2,521.21	$4,274.60