Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.79 / $48.79 / $48.79	Facility	26	$48.79	$48.79	$48.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.36 / $98.85 / $143.88	Professional		$88.36	$98.85	$143.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.27 / $53.95 / $75.97	Professional	TC	$45.27	$53.95	$75.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.98 / $128.76 / $190.86	Professional		$81.98	$128.76	$190.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.38 / $69.56 / $103.12	Professional	TC	$38.38	$69.56	$103.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.11 / $138.44 / $194.02	Professional		$100.11	$138.44	$194.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.30 / $72.81 / $101.81	Professional	TC	$46.30	$72.81	$101.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.21 / $134.04 / $199.73	Professional		$93.21	$134.04	$199.73
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $64.17 / $98.89	Professional	26	$46.15	$64.17	$98.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $47.05 / $67.22 / $100.82	Professional	TC	$47.05	$67.22	$100.82
United Facility/Professional Professional Modifier Low / Median / High Price $101.50 / $140.97 / $341.08	Professional		$101.50	$140.97	$341.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $49.27 / $71.25 / $116.03	Professional	TC	$49.27	$71.25	$116.03