Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $35.85 / $40.57 / $83.73	Facility	26	$35.85	$40.57	$83.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.13 / $209.86 / $317.47	Professional		$178.13	$209.86	$317.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.30 / $38.71 / $70.72	Professional	26	$28.30	$38.71	$70.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.46 / $169.89 / $259.95	Professional	TC	$140.46	$169.89	$259.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.64 / $201.64 / $218.42	Professional		$201.64	$201.64	$218.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.29 / $38.29 / $38.29	Professional	26	$38.29	$38.29	$38.29
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $163.34 / $163.34 / $179.99	Professional	TC	$163.34	$163.34	$179.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.27 / $43.27 / $43.27	Facility	26	$43.27	$43.27	$43.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.69 / $295.16 / $467.21	Professional		$210.69	$295.16	$467.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $50.67 / $82.24	Professional	26	$35.22	$50.67	$82.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.29 / $246.11 / $387.52	Professional	TC	$172.29	$246.11	$387.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.00 / $291.98 / $417.12	Professional		$237.00	$291.98	$417.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.69 / $56.29 / $80.41	Professional	26	$45.69	$56.29	$80.41
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $191.31 / $235.70 / $336.71	Professional	TC	$191.31	$235.70	$336.71
United Facility/Professional Professional Modifier Low / Median / High Price $217.74 / $323.83 / $451.21	Professional		$217.74	$323.83	$451.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.38 / $56.50 / $89.72	Professional	26	$37.38	$56.50	$89.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.60 / $275.12 / $369.83	Professional	TC	$183.60	$275.12	$369.83