Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $84.87 / $84.87 / $101.87	Facility	26	$84.87	$84.87	$101.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.24 / $147.19 / $222.25	Professional		$126.24	$147.19	$222.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.04 / $83.00 / $155.49	Professional	26	$72.04	$83.00	$155.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.95 / $62.29 / $95.34	Professional	TC	$53.95	$62.29	$95.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.91 / $138.94 / $150.09	Professional		$125.91	$138.94	$150.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $72.39 / $79.30 / $86.62	Professional	26	$72.39	$79.30	$86.62
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $54.03 / $59.64 / $64.47	Professional	TC	$54.03	$59.64	$64.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $124.39 / $198.04 / $286.61	Professional		$124.39	$198.04	$286.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.39 / $114.10 / $158.33	Professional	26	$87.39	$114.10	$158.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $66.02 / $89.39 / $128.29	Professional	TC	$66.02	$89.39	$128.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.22 / $193.60 / $298.35	Professional		$139.22	$193.60	$298.35
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $80.29 / $111.65 / $172.06	Professional	26	$80.29	$111.65	$172.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.94 / $82.37 / $126.29	Professional	TC	$58.94	$82.37	$126.29
United Facility/Professional Professional Modifier Low / Median / High Price $151.22 / $210.12 / $339.01	Professional		$151.22	$210.12	$339.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.40 / $118.56 / $199.59	Professional	26	$87.40	$118.56	$199.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.61 / $96.99 / $220.03	Professional	TC	$69.61	$96.99	$220.03