Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $398.11 / $831.76	Professional		$354.81	$398.11	$831.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $128.82 / $223.87	Professional	26	$102.33	$128.82	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $288.40 / $478.63	Professional	TC	$245.47	$288.40	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $537.03 / $741.31	Professional		$416.87	$537.03	$741.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $114.82 / $147.91 / $204.17	Professional	26	$114.82	$147.91	$204.17
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $389.05 / $537.03	Professional	TC	$302.00	$389.05	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $524.81 / $707.95	Professional		$354.81	$524.81	$707.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $158.49 / $213.80	Professional	26	$128.82	$158.49	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $363.08 / $489.78	Professional	TC	$223.87	$363.08	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $489.78 / $891.25	Professional		$489.78	$489.78	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $151.36 / $331.13	Professional	26	$147.91	$151.36	$331.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $338.84 / $562.34	Professional	TC	$338.84	$338.84	$562.34
Select Health Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $363.08	Professional		$346.74	$346.74	$363.08
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $107.15 / $107.15	Professional	26	$102.33	$107.15	$107.15
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $239.88 / $281.84	Professional	TC	$239.88	$239.88	$281.84
United Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $478.63 / $831.76	Professional		$371.54	$478.63	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $165.96 / $275.42	Professional	26	$125.89	$165.96	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $323.59 / $549.54	Professional	TC	$234.42	$323.59	$549.54