Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.47 / $40.47 / $40.47	Facility	26	$40.47	$40.47	$40.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.15 / $207.39 / $333.52	Professional		$173.15	$207.39	$333.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.46 / $36.65 / $57.26	Professional	26	$21.46	$36.65	$57.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.83 / $178.73 / $275.93	Professional	TC	$145.83	$178.73	$275.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $206.72 / $206.72 / $206.72	Professional		$206.72	$206.72	$206.72
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.95 / $37.95 / $37.95	Professional	26	$37.95	$37.95	$37.95
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $168.77 / $168.77 / $174.27	Professional	TC	$168.77	$168.77	$174.27
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.28 / $43.28 / $43.28	Facility	26	$43.28	$43.28	$43.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $214.14 / $300.43 / $480.13	Professional		$214.14	$300.43	$480.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $49.41 / $79.38	Professional	26	$27.61	$49.41	$79.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.08 / $253.09 / $398.58	Professional	TC	$177.08	$253.09	$398.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $248.74 / $306.44 / $437.78	Professional		$248.74	$306.44	$437.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.59 / $56.16 / $75.90	Professional	26	$45.59	$56.16	$75.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $203.15 / $250.28 / $357.54	Professional	TC	$203.15	$250.28	$357.54
United Facility/Professional Professional Modifier Low / Median / High Price $235.60 / $324.95 / $463.41	Professional		$235.60	$324.95	$463.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.70 / $57.00 / $102.85	Professional	26	$29.70	$57.00	$102.85
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.54 / $291.18 / $475.57	Professional	TC	$192.54	$291.18	$475.57