Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $168.77 / $168.77 / $203.37	Facility	26	$168.77	$168.77	$203.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.88 / $257.10 / $394.79	Professional		$228.88	$257.10	$394.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $141.72 / $160.46 / $254.84	Professional	26	$141.72	$160.46	$254.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $88.20 / $104.53 / $152.46	Professional	TC	$88.20	$104.53	$152.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.98 / $256.54 / $276.27	Professional		$234.98	$256.54	$276.27
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $143.84 / $157.58 / $166.67	Professional	26	$143.84	$157.58	$166.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $91.50 / $98.61 / $103.93	Professional	TC	$91.50	$98.61	$103.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $227.31 / $365.25 / $516.17	Professional		$227.31	$365.25	$516.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $173.49 / $227.29 / $312.51	Professional	26	$173.49	$227.29	$312.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $108.62 / $146.69 / $203.67	Professional	TC	$108.62	$146.69	$203.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $253.91 / $353.91 / $544.10	Professional		$253.91	$353.91	$544.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $159.63 / $221.98 / $342.09	Professional	26	$159.63	$221.98	$342.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $94.26 / $134.66 / $201.98	Professional	TC	$94.26	$134.66	$201.98
United Facility/Professional Professional Modifier Low / Median / High Price $278.35 / $386.37 / $611.38	Professional		$278.35	$386.37	$611.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $181.37 / $252.66 / $373.58	Professional	26	$181.37	$252.66	$373.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.05 / $142.63 / $223.20	Professional	TC	$96.05	$142.63	$223.20