Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.09 / $23.09 / $23.09	Facility	26	$23.09	$23.09	$23.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $47.03 / $134.22	Professional		$32.61	$47.03	$134.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.89 / $28.68 / $36.81	Professional	26	$17.89	$28.68	$36.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $26.09 / $97.42	Professional	TC	$14.45	$26.09	$97.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $58.47 / $102.06	Professional		$42.30	$58.47	$102.06
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $22.77 / $31.01 / $44.46	Professional	26	$22.77	$31.01	$44.46
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $43.17 / $63.45 / $153.09	Professional	50	$43.17	$63.45	$153.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.85 / $26.84 / $50.69	Professional	TC	$19.85	$26.84	$50.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.58 / $70.25 / $189.69	Professional		$40.58	$70.25	$189.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.06 / $36.28 / $65.73	Professional	26	$23.06	$36.28	$65.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $29.71 / $123.21	Professional	TC	$17.45	$29.71	$123.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.41 / $62.82 / $85.32	Professional		$50.41	$62.82	$85.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.04 / $33.70 / $45.76	Professional	26	$27.04	$33.70	$45.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.37 / $29.13 / $39.56	Professional	TC	$23.37	$29.13	$39.56
United Facility/Professional Professional Modifier Low / Median / High Price $43.60 / $69.72 / $166.10	Professional		$43.60	$69.72	$166.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.20 / $39.03 / $56.85	Professional	26	$25.20	$39.03	$56.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.66 / $29.18 / $111.83	Professional	TC	$18.66	$29.18	$111.83