Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.73 / $15.33 / $22.73	Facility	26	$12.73	$15.33	$22.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.05 / $56.06 / $85.52	Professional		$48.05	$56.06	$85.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.76 / $12.45 / $23.80	Professional	26	$10.76	$12.45	$23.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.50 / $27.78 / $35.70	Professional	52	$22.50	$27.78	$35.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.81 / $44.17 / $71.23	Professional	TC	$36.81	$44.17	$71.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.36 / $75.70 / $109.88	Professional		$56.36	$75.70	$109.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $11.86 / $15.77 / $22.89	Professional	26	$11.86	$15.77	$22.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.48 / $59.94 / $86.99	Professional	TC	$44.48	$59.94	$86.99
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.55 / $13.55 / $13.55	Facility	26	$13.55	$13.55	$13.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.99 / $75.08 / $107.02	Professional		$56.99	$75.08	$107.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.78 / $16.75 / $24.19	Professional	26	$12.78	$16.75	$24.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.18 / $58.09 / $82.21	Professional	TC	$44.18	$58.09	$82.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $80.81 / $114.62	Professional		$57.31	$80.81	$114.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.47 / $16.29 / $22.94	Professional	26	$11.47	$16.29	$22.94
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $45.84 / $64.63 / $91.68	Professional	TC	$45.84	$64.63	$91.68
United Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $79.00 / $117.71	Professional		$54.99	$79.00	$117.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.62 / $18.01 / $26.45	Professional	26	$12.62	$18.01	$26.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $42.18 / $60.33 / $88.54	Professional	TC	$42.18	$60.33	$88.54