Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.16 / $100.16 / $100.16	Facility	26	$100.16	$100.16	$100.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.19 / $106.52 / $142.68	Professional		$85.19	$106.52	$142.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.08 / $77.38 / $100.02	Professional	26	$63.08	$77.38	$100.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $30.16 / $42.66	Professional	TC	$17.73	$30.16	$42.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.79 / $139.50 / $194.65	Professional		$92.79	$139.50	$194.65
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $76.38 / $99.49 / $138.83	Professional	26	$76.38	$99.49	$138.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.64 / $42.27 / $58.12	Professional	TC	$19.64	$42.27	$58.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.83 / $122.96 / $178.92	Professional		$86.83	$122.96	$178.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.50 / $94.40 / $132.02	Professional	26	$66.50	$94.40	$132.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $28.66 / $50.58	Professional	TC	$17.45	$28.66	$50.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $135.91 / $230.01	Professional		$104.55	$135.91	$230.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.98 / $97.49 / $164.98	Professional	26	$74.98	$97.49	$164.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.56 / $38.43 / $58.99	Professional	TC	$29.56	$38.43	$58.99
United Facility/Professional Professional Modifier Low / Median / High Price $94.68 / $120.98 / $200.64	Professional		$94.68	$120.98	$200.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.33 / $94.50 / $151.41	Professional	26	$69.33	$94.50	$151.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.39 / $27.30 / $50.67	Professional	TC	$18.39	$27.30	$50.67