Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.68 / $73.02 / $75.01	Facility	26	$60.68	$73.02	$75.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $289.39 / $367.52 / $663.25	Professional		$289.39	$367.52	$663.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.32 / $58.00 / $170.00	Professional	26	$51.32	$58.00	$170.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $250.15 / $316.05 / $568.12	Professional	TC	$250.15	$316.05	$568.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.85 / $515.91 / $764.75	Professional		$309.85	$515.91	$764.75
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.81 / $73.58 / $106.96	Professional	26	$53.81	$73.58	$106.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $265.89 / $443.76 / $657.79	Professional	TC	$265.89	$443.76	$657.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.39 / $508.50 / $723.38	Professional		$285.39	$508.50	$723.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.84 / $80.76 / $112.81	Professional	26	$60.84	$80.76	$112.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.66 / $429.21 / $614.12	Professional	TC	$221.66	$429.21	$614.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $413.31 / $574.70 / $799.07	Professional		$413.31	$574.70	$799.07
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.41 / $79.83 / $123.03	Professional	26	$57.41	$79.83	$123.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $355.90 / $494.87 / $688.07	Professional	TC	$355.90	$494.87	$688.07
United Facility/Professional Professional Modifier Low / Median / High Price $303.16 / $494.39 / $858.32	Professional		$303.16	$494.39	$858.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.82 / $84.93 / $160.77	Professional	26	$62.82	$84.93	$160.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $231.55 / $421.40 / $781.32	Professional	TC	$231.55	$421.40	$781.32