Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.39 / $21.42 / $21.42	Facility	26	$20.39	$21.42	$21.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $80.36 / $180.48	Professional		$68.06	$80.36	$180.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.82 / $21.69 / $47.30	Professional	26	$17.82	$21.69	$47.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.22 / $58.93 / $95.34	Professional	TC	$50.22	$58.93	$95.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.52 / $109.29 / $175.32	Professional		$79.52	$109.29	$175.32
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $21.25 / $28.99 / $46.85	Professional	26	$21.25	$28.99	$46.85
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $58.27 / $80.08 / $128.46	Professional	TC	$58.27	$80.08	$128.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $115.21	Professional		$67.55	$67.55	$115.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $32.07	Professional	26	$18.45	$18.45	$32.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $82.51	Professional	TC	$49.10	$49.10	$82.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $80.36 / $120.92 / $151.53	Professional		$80.36	$120.92	$151.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.42 / $32.22 / $39.36	Professional	26	$21.42	$32.22	$39.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $58.94 / $88.69 / $108.33	Professional	TC	$58.94	$88.69	$108.33
United Facility/Professional Professional Modifier Low / Median / High Price $102.40 / $137.84 / $191.28	Professional		$102.40	$137.84	$191.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.42 / $33.63 / $52.33	Professional	26	$23.42	$33.63	$52.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $75.03 / $104.58 / $147.88	Professional	TC	$75.03	$104.58	$147.88