Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.43 / $11.37 / $16.89	Facility	26	$9.43	$11.37	$16.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.94 / $58.43 / $95.20	Professional		$50.94	$58.43	$95.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.45 / $8.88 / $16.80	Professional	26	$7.45	$8.88	$16.80
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $22.24 / $29.22 / $37.97	Professional	52	$22.24	$29.22	$37.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $42.95 / $49.82 / $76.66	Professional	TC	$42.95	$49.82	$76.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $79.31 / $115.12	Professional		$58.59	$79.31	$115.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.75 / $11.71 / $17.00	Professional	26	$8.75	$11.71	$17.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $50.38 / $67.59 / $98.11	Professional	TC	$50.38	$67.59	$98.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.06 / $10.06 / $10.06	Facility	26	$10.06	$10.06	$10.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.43 / $76.53 / $111.55	Professional		$58.43	$76.53	$111.55
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $11.82 / $17.93	Professional	26	$9.19	$11.82	$17.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.03 / $64.40 / $93.81	Professional	TC	$49.03	$64.40	$93.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.80 / $80.66 / $113.60	Professional		$56.80	$80.66	$113.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $12.08 / $17.02	Professional	26	$8.51	$12.08	$17.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $48.29 / $68.56 / $96.58	Professional	TC	$48.29	$68.56	$96.58
United Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $80.33 / $123.93	Professional		$56.24	$80.33	$123.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.84 / $12.74 / $18.76	Professional	26	$8.84	$12.74	$18.76
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $66.50 / $95.77	Professional	TC	$47.36	$66.50	$95.77