Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $83.18 / $100.00	Facility	26	$64.57	$83.18	$100.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $275.42 / $562.34	Professional		$190.55	$275.42	$562.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $72.44 / $186.21	Professional	26	$54.95	$72.44	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $371.54	Professional	TC	$134.90	$190.55	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $549.54	Professional		$213.80	$302.00	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $117.49	Professional	26	$61.66	$81.28	$117.49
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $213.80 / $436.52	Professional	TC	$154.88	$213.80	$436.52
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $331.13 / $660.69	Professional		$186.21	$331.13	$660.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $151.36	Professional	26	$51.29	$77.62	$151.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $245.47 / $524.81	Professional	TC	$134.90	$245.47	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $426.58 / $1,621.81	Professional		$288.40	$426.58	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $91.20 / $275.42	Professional	26	$83.18	$91.20	$275.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $229.09 / $1,348.96	Professional	TC	$208.93	$229.09	$1,348.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $295.12	Professional		$181.97	$204.17	$295.12
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $58.88 / $120.23	Professional	26	$57.54	$58.88	$120.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $147.91 / $177.83	Professional	TC	$138.04	$147.91	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $630.96	Professional		$234.42	$371.54	$630.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $89.13 / $162.18	Professional	26	$56.23	$89.13	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $295.12 / $478.63	Professional	TC	$169.82	$295.12	$478.63