Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.57 / $26.58 / $103.55	Facility	26	$26.57	$26.58	$103.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.11 / $111.23 / $313.86	Professional		$97.11	$111.23	$313.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.11 / $28.83 / $100.95	Professional	26	$23.11	$28.83	$100.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.31 / $86.57 / $137.19	Professional	TC	$70.31	$86.57	$137.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.22 / $146.76 / $206.72	Professional		$114.22	$146.76	$206.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $27.92 / $36.11 / $50.15	Professional	26	$27.92	$36.11	$50.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $86.88 / $112.03 / $157.24	Professional	TC	$86.88	$112.03	$157.24
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.20 / $28.20 / $28.20	Facility	26	$28.20	$28.20	$28.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.57 / $147.31 / $260.30	Professional		$113.57	$147.31	$260.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.29 / $36.97 / $66.03	Professional	26	$28.29	$36.97	$66.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.37 / $111.60 / $197.09	Professional	TC	$85.37	$111.60	$197.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.99 / $151.52 / $216.46	Professional		$122.99	$151.52	$216.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $29.94 / $36.88 / $52.69	Professional	26	$29.94	$36.88	$52.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $93.06 / $114.65 / $163.79	Professional	TC	$93.06	$114.65	$163.79
United Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $159.62 / $251.73	Professional		$110.84	$159.62	$251.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.28 / $39.60 / $56.91	Professional	26	$27.28	$39.60	$56.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.39 / $118.20 / $181.34	Professional	TC	$82.39	$118.20	$181.34