Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $85.11 / $102.33	Facility		$66.07	$85.11	$102.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $46.77 / $57.54	Facility	26	$37.15	$46.77	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $87.10 / $323.59	Professional		$58.88	$87.10	$323.59
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $43.65 / $107.15	Professional	26	$30.20	$43.65	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.11 / $162.18	Professional	TC	$25.12	$33.11	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $93.33 / $190.55	Professional		$66.07	$93.33	$190.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $51.29 / $87.10	Professional	26	$37.15	$51.29	$87.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $40.74 / $91.20	Professional	TC	$28.84	$40.74	$91.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Facility		$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $316.23	Professional		$75.86	$125.89	$316.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $69.18 / $128.82	Professional	26	$42.66	$69.18	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $54.95 / $194.98	Professional	TC	$33.11	$54.95	$194.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $97.72 / $407.38	Professional		$69.18	$97.72	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $53.70 / $162.18	Professional	26	$37.15	$53.70	$162.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $44.67 / $245.47	Professional	TC	$30.90	$44.67	$245.47
Select Health Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $114.82	Professional		$61.66	$69.18	$114.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $37.15 / $67.61	Professional	26	$35.48	$37.15	$67.61
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $30.90 / $47.86	Professional	TC	$26.92	$30.90	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,479.11 / $2,691.53	Facility		$676.08	$1,479.11	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $141.25 / $309.03	Professional		$74.13	$141.25	$309.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $77.62 / $131.83	Professional	26	$42.66	$77.62	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $61.66 / $186.21	Professional	TC	$31.62	$61.66	$186.21