Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.45 / $47.45 / $47.45	Facility	26	$47.45	$47.45	$47.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $86.17 / $119.53	Professional		$75.52	$86.17	$119.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.95 / $44.16 / $57.37	Professional	26	$39.95	$44.16	$57.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.71 / $41.17 / $59.08	Professional	TC	$36.71	$41.17	$59.08
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.18 / $115.77 / $172.29	Professional		$70.18	$115.77	$172.29
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.38 / $57.26 / $84.54	Professional	26	$41.38	$57.26	$84.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $31.09 / $58.53 / $87.10	Professional	TC	$31.09	$58.53	$87.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $84.62 / $121.41 / $169.02	Professional		$84.62	$121.41	$169.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.93 / $63.93 / $88.70	Professional	26	$47.93	$63.93	$88.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $35.32 / $57.31 / $80.92	Professional	TC	$35.32	$57.31	$80.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $126.47 / $190.56	Professional		$90.95	$126.47	$190.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.89 / $62.42 / $96.19	Professional	26	$44.89	$62.42	$96.19
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.06 / $63.71 / $89.06	Professional	TC	$46.06	$63.71	$89.06
United Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $123.00 / $219.25	Professional		$88.45	$123.00	$219.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.16 / $65.00 / $106.16	Professional	26	$47.16	$65.00	$106.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.21 / $55.35 / $93.80	Professional	TC	$37.21	$55.35	$93.80