Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.10 / $89.13 / $138.04	Facility	26	$87.10	$89.13	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $426.58 / $870.96	Professional		$275.42	$426.58	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $120.23 / $223.87	Professional	26	$70.79	$120.23	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $302.00 / $501.19	Professional	TC	$204.17	$302.00	$501.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $407.38 / $758.58	Professional		$295.12	$407.38	$758.58
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $93.33 / $138.04	Professional	26	$70.79	$93.33	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $263.03 / $562.34	Professional	TC	$213.80	$263.03	$562.34
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	26	$141.25	$141.25	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $446.68 / $870.96	Professional		$251.19	$446.68	$870.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $85.11 / $169.82	Professional	26	$60.26	$85.11	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $331.13 / $660.69	Professional	TC	$190.55	$331.13	$660.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $489.78 / $1,778.28	Professional		$389.05	$489.78	$1,778.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $107.15 / $263.03	Professional	26	$95.50	$107.15	$263.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $316.23 / $1,513.56	Professional	TC	$288.40	$316.23	$1,513.56
Select Health Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $275.42 / $407.38	Professional		$239.88	$275.42	$407.38
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $162.18	Professional	26	$67.61	$67.61	$162.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $204.17 / $245.47	Professional	TC	$194.98	$204.17	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $467.74 / $812.83	Professional		$288.40	$467.74	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $95.50 / $181.97	Professional	26	$60.26	$95.50	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $380.19 / $616.60	Professional	TC	$223.87	$380.19	$616.60