Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $142.53 / $175.64 / $1,411.57	Facility	26	$142.53	$175.64	$1,411.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $589.29 / $777.87 / $1,115.74	Professional		$589.29	$777.87	$1,115.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $114.29 / $137.93 / $286.60	Professional	26	$114.29	$137.93	$286.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $290.17 / $333.49 / $434.65	Professional	52	$290.17	$333.49	$434.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $476.14 / $654.21 / $927.64	Professional	TC	$476.14	$654.21	$927.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $519.05 / $692.19 / $803.23	Professional		$519.05	$692.19	$803.23
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.58 / $160.37 / $238.09	Professional	26	$120.58	$160.37	$238.09
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $423.31 / $549.88 / $680.00	Professional	TC	$423.31	$549.88	$680.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $723.98 / $1,004.12 / $1,355.20	Professional		$723.98	$1,004.12	$1,355.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.00 / $194.44 / $286.89	Professional	26	$140.00	$194.44	$286.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $600.76 / $808.29 / $1,059.33	Professional	TC	$600.76	$808.29	$1,059.33
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $698.58 / $971.35 / $1,496.95	Professional		$698.58	$971.35	$1,496.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $124.72 / $173.42 / $267.26	Professional	26	$124.72	$173.42	$267.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $573.86 / $797.93 / $1,201.98	Professional	TC	$573.86	$797.93	$1,201.98
United Facility/Professional Professional Modifier Low / Median / High Price $713.78 / $984.48 / $1,622.23	Professional		$713.78	$984.48	$1,622.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $126.48 / $205.43 / $357.62	Professional	26	$126.48	$205.43	$357.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $579.36 / $826.31 / $1,299.23	Professional	TC	$579.36	$826.31	$1,299.23