Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $68.12 / $215.65 / $280.64	Facility	26	$68.12	$215.65	$280.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.80 / $445.38 / $539.37	Professional		$367.80	$445.38	$539.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $64.40 / $78.79	Professional	26	$53.19	$64.40	$78.79
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $179.24 / $213.05 / $267.02	Professional	52	$179.24	$213.05	$267.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $309.95 / $378.40 / $473.22	Professional	TC	$309.95	$378.40	$473.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $336.37 / $444.71 / $577.66	Professional		$336.37	$444.71	$577.66
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.12 / $77.12 / $115.44	Professional	26	$58.12	$77.12	$115.44
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $290.75 / $373.50 / $511.70	Professional	TC	$290.75	$373.50	$511.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $452.96 / $622.23 / $859.00	Professional		$452.96	$622.23	$859.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.42 / $92.05 / $126.54	Professional	26	$66.42	$92.05	$126.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $388.85 / $531.34 / $724.01	Professional	TC	$388.85	$531.34	$724.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $441.00 / $613.20 / $945.00	Professional		$441.00	$613.20	$945.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.61 / $82.88 / $127.73	Professional	26	$59.61	$82.88	$127.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $381.39 / $530.32 / $817.27	Professional	TC	$381.39	$530.32	$817.27
United Facility/Professional Professional Modifier Low / Median / High Price $491.33 / $659.33 / $1,010.88	Professional		$491.33	$659.33	$1,010.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $96.48 / $171.56	Professional	26	$68.25	$96.48	$171.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $409.08 / $558.90 / $827.89	Professional	TC	$409.08	$558.90	$827.89