Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $18.93 / $18.93 / $18.93	Facility	26	$18.93	$18.93	$18.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.43 / $117.71 / $157.58	Professional		$88.43	$117.71	$157.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.73 / $14.89 / $18.88	Professional	26	$11.73	$14.89	$18.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.26 / $103.21 / $138.69	Professional	TC	$75.26	$103.21	$138.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.33 / $166.39 / $232.17	Professional		$90.33	$166.39	$232.17
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $13.85 / $19.05 / $26.53	Professional	26	$13.85	$19.05	$26.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $76.67 / $147.49 / $205.79	Professional	TC	$76.67	$147.49	$205.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.84 / $124.25 / $202.20	Professional		$82.84	$124.25	$202.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.42 / $18.14 / $27.21	Professional	26	$12.42	$18.14	$27.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.98 / $106.38 / $182.68	Professional	TC	$68.98	$106.38	$182.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.24 / $174.51 / $295.33	Professional		$134.24	$174.51	$295.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.49 / $18.84 / $31.88	Professional	26	$14.49	$18.84	$31.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $119.75 / $155.68 / $263.45	Professional	TC	$119.75	$155.68	$263.45
United Facility/Professional Professional Modifier Low / Median / High Price $87.24 / $119.10 / $204.63	Professional		$87.24	$119.10	$204.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.76 / $17.39 / $28.82	Professional	26	$13.76	$17.39	$28.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.06 / $99.20 / $179.51	Professional	TC	$72.06	$99.20	$179.51