Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.24 / $52.24 / $77.09	Facility	26	$52.24	$52.24	$77.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.59 / $105.29 / $172.81	Professional		$95.59	$105.29	$172.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.96 / $52.24 / $119.87	Professional	26	$40.96	$52.24	$119.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.20 / $61.86 / $77.95	Professional	TC	$48.20	$61.86	$77.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.56 / $135.66 / $222.55	Professional		$99.56	$135.66	$222.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.77 / $70.62 / $114.11	Professional	26	$51.77	$70.62	$114.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $64.54 / $106.32	Professional	TC	$47.36	$64.54	$106.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.50 / $148.80 / $269.37	Professional		$98.50	$148.80	$269.37
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.42 / $72.94 / $100.28	Professional	26	$47.42	$72.94	$100.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $71.28 / $124.95	Professional	TC	$42.66	$71.28	$124.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.45 / $151.16 / $189.43	Professional		$100.45	$151.16	$189.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.25 / $78.62 / $98.52	Professional	26	$52.25	$78.62	$98.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.21 / $72.54 / $90.90	Professional	TC	$48.21	$72.54	$90.90
United Facility/Professional Professional Modifier Low / Median / High Price $130.57 / $167.70 / $241.80	Professional		$130.57	$167.70	$241.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.84 / $83.73 / $130.83	Professional	26	$56.84	$83.73	$130.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.04 / $79.97 / $134.06	Professional	TC	$59.04	$79.97	$134.06