Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $63.10 / $97.72	Facility	26	$61.66	$63.10	$97.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $234.42 / $446.68	Professional		$165.96	$234.42	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $70.79 / $165.96	Professional	26	$52.48	$70.79	$165.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $154.88 / $302.00	Professional	TC	$109.65	$154.88	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $489.78	Professional		$181.97	$275.42	$489.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $77.62 / $114.82	Professional	26	$58.88	$77.62	$114.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $173.78 / $363.08	Professional	TC	$125.89	$173.78	$363.08
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	26	$117.49	$117.49	$117.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $288.40 / $549.54	Professional		$162.18	$288.40	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $70.79 / $134.90	Professional	26	$48.98	$70.79	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $204.17 / $416.87	Professional	TC	$109.65	$204.17	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $354.81 / $1,584.89	Professional		$251.19	$354.81	$1,584.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $89.13 / $288.40	Professional	26	$81.28	$89.13	$288.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $186.21 / $1,288.25	Professional	TC	$169.82	$186.21	$1,288.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $263.03	Professional		$158.49	$177.83	$263.03
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $57.54 / $117.49	Professional	26	$56.23	$57.54	$117.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $120.23 / $144.54	Professional	TC	$109.65	$120.23	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $309.03 / $524.81	Professional		$199.53	$309.03	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $79.43 / $141.25	Professional	26	$48.98	$79.43	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $239.88 / $389.05	Professional	TC	$138.04	$239.88	$389.05