Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.26 / $88.26 / $88.26	Facility	26	$88.26	$88.26	$88.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.72 / $268.42 / $467.22	Professional		$220.72	$268.42	$467.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.65 / $95.99 / $160.66	Professional	26	$76.65	$95.99	$160.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.07 / $168.30 / $257.39	Professional	TC	$144.07	$168.30	$257.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $268.51 / $345.02 / $485.98	Professional		$268.51	$345.02	$485.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $92.09 / $120.39 / $166.06	Professional	26	$92.09	$120.39	$166.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $177.13 / $227.60 / $320.58	Professional	TC	$177.13	$227.60	$320.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.46 / $93.46 / $93.46	Facility	26	$93.46	$93.46	$93.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.45 / $346.08 / $610.75	Professional		$264.45	$346.08	$610.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $95.36 / $123.39 / $210.48	Professional	26	$95.36	$123.39	$210.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $167.58 / $223.31 / $385.97	Professional	TC	$167.58	$223.31	$385.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.91 / $355.94 / $508.49	Professional		$288.91	$355.94	$508.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $99.39 / $122.45 / $174.92	Professional	26	$99.39	$122.45	$174.92
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $189.53 / $233.49 / $333.56	Professional	TC	$189.53	$233.49	$333.56
United Facility/Professional Professional Modifier Low / Median / High Price $265.19 / $366.08 / $568.13	Professional		$265.19	$366.08	$568.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $91.96 / $136.50 / $200.47	Professional	26	$91.96	$136.50	$200.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $166.23 / $231.54 / $357.83	Professional	TC	$166.23	$231.54	$357.83