Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $107.15 / $107.15	Facility	26	$83.18	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $346.74 / $707.95	Professional		$288.40	$346.74	$707.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $104.71 / $269.15	Professional	26	$81.28	$104.71	$269.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $245.47 / $489.78	Professional	TC	$204.17	$245.47	$489.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $446.68 / $616.60	Professional		$346.74	$446.68	$616.60
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $120.23 / $162.18	Professional	26	$93.33	$120.23	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $323.59 / $446.68	Professional	TC	$257.04	$323.59	$446.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $457.09 / $602.56	Professional		$363.08	$457.09	$602.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $128.82 / $169.82	Professional	26	$102.33	$128.82	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $331.13 / $416.87	Professional	TC	$257.04	$331.13	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $407.38 / $870.96	Professional		$398.11	$407.38	$870.96
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $120.23 / $245.47	Professional	26	$120.23	$120.23	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $281.84 / $630.96	Professional	TC	$275.42	$281.84	$630.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $302.00	Professional		$281.84	$281.84	$302.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $85.11 / $85.11	Professional	26	$81.28	$85.11	$85.11
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $199.53 / $199.53 / $234.42	Professional	TC	$199.53	$199.53	$234.42
United Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $707.95	Professional		$316.23	$457.09	$707.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $128.82 / $218.78	Professional	26	$100.00	$128.82	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $331.13 / $489.78	Professional	TC	$234.42	$331.13	$489.78