Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.95 / $64.95 / $64.95	Facility	26	$64.95	$64.95	$64.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.18 / $102.50 / $170.31	Professional		$93.18	$102.50	$170.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.97 / $64.95 / $103.96	Professional	26	$58.97	$64.95	$103.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.38 / $40.22 / $77.38	Professional	TC	$30.38	$40.22	$77.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.98 / $150.71 / $219.12	Professional		$108.98	$150.71	$219.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $64.08 / $83.42 / $121.14	Professional	26	$64.08	$83.42	$121.14
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.04 / $66.79 / $97.97	Professional	TC	$47.04	$66.79	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.96 / $137.43 / $231.80	Professional		$105.96	$137.43	$231.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.19 / $88.27 / $147.49	Professional	26	$68.19	$88.27	$147.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.40 / $51.52 / $80.06	Professional	TC	$32.40	$51.52	$80.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.08 / $145.71 / $260.20	Professional		$104.08	$145.71	$260.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.52 / $81.93 / $146.30	Professional	26	$58.52	$81.93	$146.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.57 / $63.80 / $113.93	Professional	TC	$45.57	$63.80	$113.93
United Facility/Professional Professional Modifier Low / Median / High Price $98.79 / $137.69 / $202.82	Professional		$98.79	$137.69	$202.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.40 / $92.90 / $140.29	Professional	26	$68.40	$92.90	$140.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.78 / $49.02 / $72.17	Professional	TC	$30.78	$49.02	$72.17