Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $57.68 / $77.81	Professional		$40.76	$57.68	$77.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.88 / $18.55 / $25.86	Professional	26	$15.88	$18.55	$25.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.78 / $37.61 / $51.95	Professional	TC	$24.78	$37.61	$51.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.31 / $80.31 / $165.44	Professional		$80.31	$80.31	$165.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.41 / $25.41 / $52.35	Professional	26	$25.41	$25.41	$52.35
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.90 / $54.90 / $113.09	Professional	TC	$54.90	$54.90	$113.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $38.95 / $115.06	Professional		$23.30	$38.95	$115.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.63 / $13.29 / $44.72	Professional	26	$10.63	$13.29	$44.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $12.66 / $26.89 / $75.20	Professional	TC	$12.66	$26.89	$75.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.87 / $120.54 / $311.99	Professional		$101.87	$120.54	$311.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.28 / $34.65 / $91.36	Professional	26	$29.28	$34.65	$91.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.58 / $85.88 / $218.09	Professional	TC	$72.58	$85.88	$218.09
United Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $41.79 / $128.10	Professional		$32.61	$41.79	$128.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.56 / $15.81 / $60.28	Professional	26	$14.56	$15.81	$60.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.10 / $34.15 / $89.21	Professional	TC	$19.10	$34.15	$89.21