Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $93.33 / $128.82	Facility	26	$83.18	$93.33	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $288.40 / $630.96	Professional		$218.78	$288.40	$630.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $213.80	Professional	26	$61.66	$91.20	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $204.17 / $371.54	Professional	TC	$144.54	$204.17	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $575.44	Professional		$239.88	$331.13	$575.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $102.33 / $151.36	Professional	26	$77.62	$102.33	$151.36
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $426.58	Professional	TC	$158.49	$213.80	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $154.88 / $154.88 / $154.88	Facility	26	$154.88	$154.88	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $346.74 / $660.69	Professional		$208.93	$346.74	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $169.82	Professional	26	$64.57	$89.13	$169.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $251.19 / $501.19	Professional	TC	$144.54	$251.19	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $426.58 / $1,288.25	Professional		$323.59	$426.58	$1,288.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $107.15 / $117.49 / $269.15	Professional	26	$107.15	$117.49	$269.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $239.88 / $1,023.29	Professional	TC	$218.78	$239.88	$1,023.29
Select Health Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $229.09 / $338.84	Professional		$204.17	$229.09	$338.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $75.86 / $154.88	Professional	26	$74.13	$75.86	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $154.88 / $186.21	Professional	TC	$144.54	$154.88	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $371.54 / $616.60	Professional		$245.47	$371.54	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $107.15 / $181.97	Professional	26	$60.26	$107.15	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $281.84 / $457.09	Professional	TC	$169.82	$281.84	$457.09