Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.58 / $12.58 / $17.09	Facility	26	$12.58	$12.58	$17.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.84 / $112.48 / $155.97	Professional		$75.84	$112.48	$155.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.16 / $12.59 / $21.02	Professional	26	$11.16	$12.59	$21.02
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $37.86 / $45.91 / $59.70	Professional	52	$37.86	$45.91	$59.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.23 / $104.06 / $132.31	Professional	TC	$65.23	$104.06	$132.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.75 / $86.75 / $113.09	Professional		$86.75	$86.75	$113.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.20 / $12.20 / $12.53	Professional	26	$12.20	$12.20	$12.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.55 / $74.55 / $91.54	Professional	TC	$74.55	$74.55	$91.54
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.54 / $13.54 / $13.54	Facility	26	$13.54	$13.54	$13.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $90.45 / $132.69 / $205.74	Professional		$90.45	$132.69	$205.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.48 / $17.21 / $30.89	Professional	26	$12.48	$17.21	$30.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.44 / $115.80 / $178.66	Professional	TC	$77.44	$115.80	$178.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.40 / $127.39 / $181.98	Professional		$103.40	$127.39	$181.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $14.18 / $17.46 / $24.95	Professional	26	$14.18	$17.46	$24.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.23 / $109.93 / $157.04	Professional	TC	$89.23	$109.93	$157.04
United Facility/Professional Professional Modifier Low / Median / High Price $96.01 / $149.01 / $291.76	Professional		$96.01	$149.01	$291.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.32 / $18.70 / $28.80	Professional	26	$13.32	$18.70	$28.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.61 / $125.17 / $179.40	Professional	TC	$81.61	$125.17	$179.40