Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.70 / $65.86 / $111.36	Professional		$48.70	$65.86	$111.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.47 / $14.46 / $21.81	Professional	26	$12.47	$14.46	$21.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.46 / $51.40 / $89.55	Professional	TC	$34.46	$51.40	$89.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.23 / $95.23 / $196.16	Professional		$95.23	$95.23	$196.16
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $20.67 / $20.67 / $42.58	Professional	26	$20.67	$20.67	$42.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $74.55 / $153.58	Professional	TC	$74.55	$74.55	$153.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $47.06 / $139.86	Professional		$37.44	$47.06	$139.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.69 / $11.64 / $44.00	Professional	26	$9.69	$11.64	$44.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.12 / $37.32 / $106.73	Professional	TC	$28.12	$37.32	$106.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $123.06 / $340.73	Professional		$103.99	$123.06	$340.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.84 / $27.02 / $73.54	Professional	26	$22.84	$27.02	$73.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $81.16 / $96.03 / $267.19	Professional	TC	$81.16	$96.03	$267.19
United Facility/Professional Professional Modifier Low / Median / High Price $52.37 / $59.11 / $197.04	Professional		$52.37	$59.11	$197.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $13.86 / $46.20	Professional	26	$12.20	$13.86	$46.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.95 / $45.25 / $150.84	Professional	TC	$38.95	$45.25	$150.84