Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $136.75 / $136.76 / $461.53	Facility	26	$136.75	$136.76	$461.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $563.67 / $720.28 / $1,065.40	Professional		$563.67	$720.28	$1,065.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.16 / $132.51 / $344.14	Professional	26	$110.16	$132.51	$344.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $277.83 / $320.37 / $416.28	Professional	52	$277.83	$320.37	$416.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $451.82 / $602.07 / $884.77	Professional	TC	$451.82	$602.07	$884.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $496.52 / $662.13 / $767.84	Professional		$496.52	$662.13	$767.84
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $115.91 / $154.65 / $229.58	Professional	26	$115.91	$154.65	$229.58
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $404.48 / $513.22 / $671.31	Professional	TC	$404.48	$513.22	$671.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $689.48 / $946.34 / $1,264.96	Professional		$689.48	$946.34	$1,264.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $133.65 / $185.83 / $271.47	Professional	26	$133.65	$185.83	$271.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $561.59 / $755.38 / $976.77	Professional	TC	$561.59	$755.38	$976.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $667.05 / $927.52 / $1,429.40	Professional		$667.05	$927.52	$1,429.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $119.67 / $166.40 / $256.43	Professional	26	$119.67	$166.40	$256.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $547.39 / $761.13 / $1,172.97	Professional	TC	$547.39	$761.13	$1,172.97
United Facility/Professional Professional Modifier Low / Median / High Price $688.40 / $1,000.16 / $1,451.12	Professional		$688.40	$1,000.16	$1,451.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $129.16 / $198.00 / $344.36	Professional	26	$129.16	$198.00	$344.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $538.46 / $747.74 / $1,194.47	Professional	TC	$538.46	$747.74	$1,194.47