Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.87 / $24.87 / $24.87	Facility	26	$24.87	$24.87	$24.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $116.45 / $171.13 / $208.01	Professional		$116.45	$171.13	$208.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.76 / $22.95 / $35.07	Professional	26	$18.76	$22.95	$35.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.12 / $150.77 / $178.34	Professional	TC	$94.12	$150.77	$178.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $130.81 / $130.81 / $156.97	Professional		$130.81	$130.81	$156.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.06 / $24.06 / $24.06	Professional	26	$24.06	$24.06	$24.06
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.09 / $107.09 / $135.26	Professional	TC	$107.09	$107.09	$135.26
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $27.06 / $27.06 / $27.06	Facility	26	$27.06	$27.06	$27.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.28 / $193.94 / $313.11	Professional		$138.28	$193.94	$313.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.00 / $32.72 / $53.20	Professional	26	$23.00	$32.72	$53.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.48 / $161.43 / $261.89	Professional	TC	$112.48	$161.43	$261.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $155.13 / $191.11 / $273.02	Professional		$155.13	$191.11	$273.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.01 / $34.51 / $45.78	Professional	26	$28.01	$34.51	$45.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $127.13 / $156.62 / $223.74	Professional	TC	$127.13	$156.62	$223.74
United Facility/Professional Professional Modifier Low / Median / High Price $145.60 / $220.70 / $328.43	Professional		$145.60	$220.70	$328.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.97 / $36.09 / $56.11	Professional	26	$24.97	$36.09	$56.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.87 / $187.59 / $242.16	Professional	TC	$121.87	$187.59	$242.16