Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.57 / $48.57 / $48.57	Facility	26	$48.57	$48.57	$48.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.89 / $348.04 / $508.81	Professional		$292.89	$348.04	$508.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $152.80 / $182.75 / $239.68	Professional	52	$152.80	$182.75	$239.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $252.77 / $303.33 / $450.21	Professional	TC	$252.77	$303.33	$450.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.29 / $493.23 / $728.24	Professional		$295.29	$493.23	$728.24
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.79 / $435.10 / $642.41	Professional	TC	$251.79	$435.10	$642.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.55 / $495.24 / $694.07	Professional		$330.55	$495.24	$694.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $317.68 / $436.81 / $606.05	Professional	TC	$317.68	$436.81	$606.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $397.55 / $552.79 / $851.90	Professional		$397.55	$552.79	$851.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $63.89 / $98.46	Professional	26	$45.95	$63.89	$98.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $351.61 / $488.91 / $753.46	Professional	TC	$351.61	$488.91	$753.46
United Facility/Professional Professional Modifier Low / Median / High Price $356.57 / $495.33 / $812.98	Professional		$356.57	$495.33	$812.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.93 / $419.44 / $704.36	Professional	TC	$308.93	$419.44	$704.36