Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $113.03 / $113.03 / $136.91	Facility	26	$113.03	$113.03	$136.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.50 / $190.30 / $283.95	Professional		$165.50	$190.30	$283.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $94.84 / $111.32 / $194.36	Professional	26	$94.84	$111.32	$194.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.38 / $79.70 / $121.40	Professional	TC	$70.38	$79.70	$121.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.74 / $181.98 / $196.01	Professional		$165.74	$181.98	$196.01
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $96.42 / $105.39 / $115.36	Professional	26	$96.42	$105.39	$115.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.69 / $76.25 / $83.56	Professional	TC	$69.69	$76.25	$83.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.56 / $264.33 / $376.92	Professional		$162.56	$264.33	$376.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $116.55 / $152.52 / $211.95	Professional	26	$116.55	$152.52	$211.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $84.06 / $115.84 / $164.96	Professional	TC	$84.06	$115.84	$164.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $181.94 / $252.99 / $389.88	Professional		$181.94	$252.99	$389.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $106.92 / $148.66 / $229.12	Professional	26	$106.92	$148.66	$229.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $75.02 / $105.45 / $160.76	Professional	TC	$75.02	$105.45	$160.76
United Facility/Professional Professional Modifier Low / Median / High Price $195.35 / $281.32 / $493.87	Professional		$195.35	$281.32	$493.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $116.66 / $158.60 / $297.95	Professional	26	$116.66	$158.60	$297.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $86.28 / $122.72 / $188.50	Professional	TC	$86.28	$122.72	$188.50