Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.03 / $63.03 / $349.44	Facility	26	$63.03	$63.03	$349.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $167.10 / $763.56	Professional		$133.76	$167.10	$763.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.92 / $95.98 / $776.83	Professional	26	$56.92	$95.98	$776.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $94.98 / $148.13	Professional	TC	$70.73	$94.98	$148.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.30 / $181.37 / $290.94	Professional		$136.30	$181.37	$290.94
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $65.01 / $85.74 / $137.53	Professional	26	$65.01	$85.74	$137.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.22 / $95.63 / $157.54	Professional	TC	$71.22	$95.63	$157.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $197.28 / $289.00	Professional		$132.94	$197.28	$289.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.32 / $89.02 / $123.37	Professional	26	$57.32	$89.02	$123.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.37 / $114.25 / $182.30	Professional	TC	$63.37	$114.25	$182.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $133.76 / $201.28 / $252.23	Professional		$133.76	$201.28	$252.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.02 / $94.83 / $118.84	Professional	26	$63.02	$94.83	$118.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.73 / $106.44 / $133.38	Professional	TC	$70.73	$106.44	$133.38
United Facility/Professional Professional Modifier Low / Median / High Price $175.88 / $218.87 / $325.70	Professional		$175.88	$218.87	$325.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.42 / $102.99 / $157.00	Professional	26	$73.42	$102.99	$157.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $93.49 / $124.84 / $168.70	Professional	TC	$93.49	$124.84	$168.70