Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $86.63 / $86.63 / $104.41	Facility	26	$86.63	$86.63	$104.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.08 / $159.60 / $234.55	Professional		$130.08	$159.60	$234.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.72 / $82.55 / $124.21	Professional	26	$72.72	$82.55	$124.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.03 / $81.30 / $124.88	Professional	TC	$55.03	$81.30	$124.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.40 / $210.93 / $316.39	Professional		$143.40	$210.93	$316.39
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.88 / $105.74 / $154.53	Professional	26	$77.88	$105.74	$154.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $68.14 / $109.75 / $162.68	Professional	TC	$68.14	$109.75	$162.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.24 / $217.17 / $339.25	Professional		$131.24	$217.17	$339.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.65 / $115.88 / $162.29	Professional	26	$87.65	$115.88	$162.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $50.08 / $116.93 / $176.95	Professional	TC	$50.08	$116.93	$176.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $162.34 / $231.01 / $347.87	Professional		$162.34	$231.01	$347.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.94 / $113.94 / $175.59	Professional	26	$81.94	$113.94	$175.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $80.39 / $114.84 / $172.26	Professional	TC	$80.39	$114.84	$172.26
United Facility/Professional Professional Modifier Low / Median / High Price $152.28 / $232.80 / $413.96	Professional		$152.28	$232.80	$413.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.17 / $119.36 / $194.19	Professional	26	$85.17	$119.36	$194.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.57 / $122.01 / $206.55	Professional	TC	$54.57	$122.01	$206.55