Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.66 / $46.66 / $46.66	Facility	26	$46.66	$46.66	$46.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.71 / $151.71 / $228.35	Professional		$114.71	$151.71	$228.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.26 / $46.66 / $66.62	Professional	26	$38.26	$46.66	$66.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.33 / $106.59 / $160.99	Professional	TC	$77.33	$106.59	$160.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.78 / $205.97 / $287.38	Professional		$158.78	$205.97	$287.38
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.81 / $62.47 / $87.43	Professional	26	$48.81	$62.47	$87.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $110.47 / $142.94 / $199.95	Professional	TC	$110.47	$142.94	$199.95
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.06 / $49.06 / $49.06	Facility	26	$49.06	$49.06	$49.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.27 / $207.84 / $372.12	Professional		$150.27	$207.84	$372.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.26 / $64.48 / $119.02	Professional	26	$49.26	$64.48	$119.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.54 / $143.33 / $240.62	Professional	TC	$102.54	$143.33	$240.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $170.30 / $209.81 / $299.73	Professional		$170.30	$209.81	$299.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.55 / $64.73 / $92.49	Professional	26	$52.55	$64.73	$92.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $117.75 / $145.07 / $207.24	Professional	TC	$117.75	$145.07	$207.24
United Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $220.95 / $317.39	Professional		$144.00	$220.95	$317.39
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.36 / $68.48 / $105.30	Professional	26	$47.36	$68.48	$105.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.81 / $158.85 / $220.40	Professional	TC	$97.81	$158.85	$220.40