Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $200.21 / $200.22 / $200.22	Facility	26	$200.21	$200.22	$200.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.75 / $296.58 / $462.01	Professional		$266.75	$296.58	$462.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $168.11 / $190.21 / $308.25	Professional	26	$168.11	$190.21	$308.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.42 / $115.98 / $174.46	Professional	TC	$97.42	$115.98	$174.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $272.05 / $295.85 / $318.83	Professional		$272.05	$295.85	$318.83
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $170.06 / $187.07 / $203.48	Professional	26	$170.06	$187.07	$203.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $101.76 / $109.12 / $115.09	Professional	TC	$101.76	$109.12	$115.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $266.02 / $423.33 / $597.27	Professional		$266.02	$423.33	$597.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $205.63 / $268.69 / $371.02	Professional	26	$205.63	$268.69	$371.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $119.97 / $162.47 / $226.24	Professional	TC	$119.97	$162.47	$226.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $297.24 / $413.31 / $636.95	Professional		$297.24	$413.31	$636.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $189.40 / $263.35 / $405.86	Professional	26	$189.40	$263.35	$405.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.86 / $150.50 / $231.12	Professional	TC	$107.86	$150.50	$231.12
United Facility/Professional Professional Modifier Low / Median / High Price $326.43 / $440.73 / $787.20	Professional		$326.43	$440.73	$787.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $214.40 / $287.26 / $528.36	Professional	26	$214.40	$287.26	$528.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.45 / $163.50 / $258.38	Professional	TC	$121.45	$163.50	$258.38