Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.84 / $81.09 / $210.90	Facility	26	$50.84	$81.09	$210.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.98 / $148.31 / $203.97	Professional		$92.98	$148.31	$203.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.14 / $59.07 / $111.83	Professional	26	$42.14	$59.07	$111.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $43.74 / $57.83 / $75.70	Professional	52	$43.74	$57.83	$75.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $49.52 / $91.62 / $136.38	Professional	TC	$49.52	$91.62	$136.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.08 / $112.13 / $300.00	Professional		$85.08	$112.13	$300.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.09 / $61.24 / $87.36	Professional	26	$43.09	$61.24	$87.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.22 / $60.52 / $220.00	Professional	TC	$46.22	$60.52	$220.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.04 / $188.08 / $333.84	Professional		$112.04	$188.08	$333.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.76 / $77.63 / $126.64	Professional	26	$50.76	$77.63	$126.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.62 / $113.76 / $207.19	Professional	TC	$60.62	$113.76	$207.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.20 / $140.71 / $216.86	Professional		$101.20	$140.71	$216.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.49 / $61.86 / $95.33	Professional	26	$44.49	$61.86	$95.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.71 / $78.84 / $121.52	Professional	TC	$56.71	$78.84	$121.52
United Facility/Professional Professional Modifier Low / Median / High Price $138.61 / $224.91 / $331.20	Professional		$138.61	$224.91	$331.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.61 / $78.52 / $128.02	Professional	26	$53.61	$78.52	$128.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $80.20 / $139.36 / $202.92	Professional	TC	$80.20	$139.36	$202.92