Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.09 / $141.09 / $170.03	Facility	26	$141.09	$141.09	$170.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.81 / $230.61 / $348.22	Professional		$199.81	$230.61	$348.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $119.42 / $138.38 / $249.91	Professional	26	$119.42	$138.38	$249.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $79.01 / $92.39 / $137.05	Professional	TC	$79.01	$92.39	$137.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $200.36 / $219.26 / $236.33	Professional		$200.36	$219.26	$236.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $120.44 / $131.49 / $144.11	Professional	26	$120.44	$131.49	$144.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $80.87 / $87.77 / $94.24	Professional	TC	$80.87	$87.77	$94.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $195.06 / $315.63 / $451.26	Professional		$195.06	$315.63	$451.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $145.49 / $190.61 / $262.32	Professional	26	$145.49	$190.61	$262.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $96.58 / $132.63 / $188.95	Professional	TC	$96.58	$132.63	$188.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.15 / $303.33 / $467.46	Professional		$218.15	$303.33	$467.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $133.46 / $185.57 / $285.98	Professional	26	$133.46	$185.57	$285.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.68 / $120.98 / $181.46	Professional	TC	$84.68	$120.98	$181.46
United Facility/Professional Professional Modifier Low / Median / High Price $253.11 / $346.32 / $505.85	Professional		$253.11	$346.32	$505.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $145.19 / $198.13 / $373.42	Professional	26	$145.19	$198.13	$373.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.66 / $142.47 / $215.94	Professional	TC	$98.66	$142.47	$215.94