Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $159.80 / $159.80 / $159.80	Facility	26	$159.80	$159.80	$159.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.18 / $299.02 / $502.36	Professional		$255.18	$299.02	$502.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $131.81 / $159.80 / $290.68	Professional	26	$131.81	$159.80	$290.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.37 / $145.68 / $238.86	Professional	TC	$123.37	$145.68	$238.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $301.66 / $414.56 / $665.01	Professional		$301.66	$414.56	$665.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $157.68 / $215.14 / $347.62	Professional	26	$157.68	$215.14	$347.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $143.97 / $197.86 / $317.39	Professional	TC	$143.97	$197.86	$317.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.36 / $424.43 / $576.23	Professional		$271.36	$424.43	$576.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $146.94 / $221.75 / $310.20	Professional	26	$146.94	$221.75	$310.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.18 / $202.68 / $271.99	Professional	TC	$130.18	$202.68	$271.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $307.56 / $462.80 / $579.96	Professional		$307.56	$462.80	$579.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $159.80 / $240.46 / $301.33	Professional	26	$159.80	$240.46	$301.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $147.76 / $222.34 / $278.63	Professional	TC	$147.76	$222.34	$278.63
United Facility/Professional Professional Modifier Low / Median / High Price $359.31 / $486.20 / $834.15	Professional		$359.31	$486.20	$834.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $189.80 / $252.88 / $428.16	Professional	26	$189.80	$252.88	$428.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.51 / $227.27 / $390.62	Professional	TC	$169.51	$227.27	$390.62