Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.97 / $45.97 / $54.08	Facility	26	$45.97	$45.97	$54.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.00 / $154.94 / $267.42	Professional		$120.00	$154.94	$267.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.09 / $45.97 / $119.09	Professional	26	$37.09	$45.97	$119.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.22 / $96.91 / $200.77	Professional	TC	$72.22	$96.91	$200.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.91 / $199.82 / $288.74	Professional		$132.91	$199.82	$288.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.15 / $59.82 / $86.08	Professional	26	$44.15	$59.82	$86.08
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $160.02 / $185.73 / $287.08	Professional	50	$160.02	$185.73	$287.08
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.48 / $141.87 / $202.66	Professional	TC	$85.48	$141.87	$202.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.69 / $172.76 / $256.06	Professional		$120.69	$172.76	$256.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.48 / $61.58 / $91.96	Professional	26	$42.48	$61.58	$91.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.83 / $107.86 / $180.19	Professional	TC	$75.83	$107.86	$180.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $207.39 / $258.44 / $340.00	Professional		$207.39	$258.44	$340.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $67.08 / $91.10	Professional	26	$53.83	$67.08	$91.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $153.56 / $188.99 / $233.88	Professional	TC	$153.56	$188.99	$233.88
United Facility/Professional Professional Modifier Low / Median / High Price $109.93 / $177.65 / $301.81	Professional		$109.93	$177.65	$301.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.19 / $66.13 / $110.08	Professional	26	$44.19	$66.13	$110.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.92 / $108.37 / $176.13	Professional	TC	$62.92	$108.37	$176.13