Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $306.89 / $306.89 / $306.89	Facility	26	$306.89	$306.89	$306.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,068.84 / $1,133.92 / $1,748.23	Professional		$1,068.84	$1,133.92	$1,748.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $284.63 / $318.36 / $1,030.92	Professional	26	$284.63	$318.36	$1,030.92
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $779.44 / $815.25 / $1,281.18	Professional	TC	$779.44	$815.25	$1,281.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,199.67 / $1,483.17 / $2,148.33	Professional		$1,199.67	$1,483.17	$2,148.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $315.38 / $389.92 / $564.78	Professional	26	$315.38	$389.92	$564.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $884.28 / $1,093.25 / $1,583.54	Professional	TC	$884.28	$1,093.25	$1,583.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,260.11 / $1,601.64 / $2,120.66	Professional		$1,260.11	$1,601.64	$2,120.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $370.74 / $451.34 / $582.16	Professional	26	$370.74	$451.34	$582.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $916.81 / $1,180.81 / $1,540.75	Professional	TC	$916.81	$1,180.81	$1,540.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,077.70 / $1,536.72 / $1,975.78	Professional		$1,077.70	$1,536.72	$1,975.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $298.61 / $425.79 / $547.45	Professional	26	$298.61	$425.79	$547.45
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $779.09 / $1,110.93 / $1,428.33	Professional	TC	$779.09	$1,110.93	$1,428.33
United Facility/Professional Professional Modifier Low / Median / High Price $1,307.63 / $1,707.75 / $3,717.63	Professional		$1,307.63	$1,707.75	$3,717.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $368.09 / $480.42 / $839.13	Professional	26	$368.09	$480.42	$839.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $804.10 / $1,167.05 / $1,971.37	Professional	TC	$804.10	$1,167.05	$1,971.37