Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.68 / $60.68 / $73.48	Facility	26	$60.68	$60.68	$73.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.67 / $420.95 / $773.65	Professional		$338.67	$420.95	$773.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.15 / $59.90 / $179.69	Professional	26	$51.15	$59.90	$179.69
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $286.04 / $382.35 / $677.03	Professional	TC	$286.04	$382.35	$677.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $362.05 / $591.82 / $887.73	Professional		$362.05	$591.82	$887.73
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.81 / $73.58 / $107.28	Professional	26	$53.81	$73.58	$107.28
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $298.64 / $526.72 / $780.76	Professional	TC	$298.64	$526.72	$780.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.11 / $594.94 / $859.33	Professional		$300.11	$594.94	$859.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.08 / $80.98 / $113.51	Professional	26	$61.08	$80.98	$113.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.42 / $524.28 / $745.82	Professional	TC	$249.42	$524.28	$745.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $481.54 / $669.57 / $1,031.86	Professional		$481.54	$669.57	$1,031.86
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 $424.14 / $589.75 / $820.00	Professional	TC	$424.14	$589.75	$820.00
United Facility/Professional Professional Modifier Low / Median / High Price $327.42 / $587.04 / $1,013.40	Professional		$327.42	$587.04	$1,013.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $62.32 / $83.37 / $135.77	Professional	26	$62.32	$83.37	$135.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $246.50 / $486.68 / $852.12	Professional	TC	$246.50	$486.68	$852.12