Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $108.90 / $108.90 / $108.90	Facility	26	$108.90	$108.90	$108.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $242.28 / $325.20 / $466.53	Professional		$242.28	$325.20	$466.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.97 / $103.75 / $139.71	Professional	26	$90.97	$103.75	$139.71
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $148.65 / $216.31 / $330.97	Professional	TC	$148.65	$216.31	$330.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $238.08 / $374.95 / $545.05	Professional		$238.08	$374.95	$545.05
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.36 / $131.62 / $192.79	Professional	26	$93.36	$131.62	$192.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $151.85 / $242.33 / $352.27	Professional	TC	$151.85	$242.33	$352.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.55 / $396.19 / $566.13	Professional		$280.55	$396.19	$566.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $109.15 / $145.19 / $202.12	Professional	26	$109.15	$145.19	$202.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.92 / $250.37 / $381.05	Professional	TC	$179.92	$250.37	$381.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $307.63 / $427.75 / $659.21	Professional		$307.63	$427.75	$659.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.02 / $143.24 / $220.75	Professional	26	$103.02	$143.24	$220.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $204.62 / $284.52 / $438.48	Professional	TC	$204.62	$284.52	$438.48
United Facility/Professional Professional Modifier Low / Median / High Price $296.16 / $405.26 / $659.35	Professional		$296.16	$405.26	$659.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.34 / $149.51 / $241.91	Professional	26	$112.34	$149.51	$241.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.91 / $258.01 / $425.95	Professional	TC	$177.91	$258.01	$425.95