Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.75 / $47.75 / $47.75	Facility	26	$47.75	$47.75	$47.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.42 / $140.96 / $196.63	Professional		$115.42	$140.96	$196.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.11 / $45.43 / $61.63	Professional	26	$40.11	$45.43	$61.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.14 / $93.96 / $128.37	Professional	TC	$75.14	$93.96	$128.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.20 / $167.86 / $244.35	Professional		$114.20	$167.86	$244.35
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $57.60 / $84.54	Professional	26	$41.69	$57.60	$84.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $71.81 / $109.70 / $160.16	Professional	TC	$71.81	$109.70	$160.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.72 / $192.11 / $267.41	Professional		$134.72	$192.11	$267.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.24 / $64.17 / $89.94	Professional	26	$48.24	$64.17	$89.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $85.66 / $123.98 / $190.67	Professional	TC	$85.66	$123.98	$190.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $124.49 / $177.84 / $266.76	Professional		$124.49	$177.84	$266.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.17 / $62.81 / $96.80	Professional	26	$45.17	$62.81	$96.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.31 / $113.31 / $169.97	Professional	TC	$79.31	$113.31	$169.97
United Facility/Professional Professional Modifier Low / Median / High Price $139.19 / $189.29 / $328.43	Professional		$139.19	$189.29	$328.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.24 / $66.19 / $128.41	Professional	26	$47.24	$66.19	$128.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.39 / $120.46 / $223.49	Professional	TC	$88.39	$120.46	$223.49