Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.88 / $48.88 / $59.21	Facility	26	$48.88	$48.88	$59.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.81 / $252.59 / $436.57	Professional		$195.81	$252.59	$436.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.71 / $48.88 / $70.01	Professional	26	$41.71	$48.88	$70.01
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $208.65 / $366.55	Professional	TC	$162.49	$208.65	$366.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $285.69 / $285.69 / $285.69	Professional		$285.69	$285.69	$285.69
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $46.09 / $46.09 / $52.66	Professional	26	$46.09	$46.09	$52.66
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $239.94 / $239.94 / $239.94	Professional	TC	$239.94	$239.94	$239.94
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.19 / $52.19 / $52.19	Facility	26	$52.19	$52.19	$52.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.51 / $399.85 / $626.33	Professional		$281.51	$399.85	$626.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.77 / $65.43 / $103.42	Professional	26	$47.77	$65.43	$103.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.84 / $334.38 / $529.16	Professional	TC	$231.84	$334.38	$529.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $324.70 / $400.05 / $571.49	Professional		$324.70	$400.05	$571.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.05 / $67.81 / $96.89	Professional	26	$55.05	$67.81	$96.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.66 / $332.22 / $474.61	Professional	TC	$269.66	$332.22	$474.61
United Facility/Professional Professional Modifier Low / Median / High Price $308.00 / $441.85 / $611.36	Professional		$308.00	$441.85	$611.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.58 / $69.68 / $107.19	Professional	26	$49.58	$69.68	$107.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $254.00 / $363.76 / $508.00	Professional	TC	$254.00	$363.76	$508.00