Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	26	$64.57	$64.57	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $436.52	Professional		$190.55	$263.03	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $64.57 / $128.82	Professional	26	$52.48	$64.57	$128.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $331.13	Professional	TC	$134.90	$190.55	$331.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $302.00 / $549.54	Professional		$218.78	$302.00	$549.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $81.28 / $120.23	Professional	26	$61.66	$81.28	$120.23
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 $120.23 / $120.23 / $120.23	Facility	26	$120.23	$120.23	$120.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $331.13 / $645.65	Professional		$190.55	$331.13	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $72.44 / $138.04	Professional	26	$51.29	$72.44	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $251.19 / $524.81	Professional	TC	$134.90	$251.19	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $416.87 / $1,548.82	Professional		$295.12	$416.87	$1,548.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $93.33 / $245.47	Professional	26	$85.11	$93.33	$245.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $229.09 / $1,288.25	Professional	TC	$208.93	$229.09	$1,288.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $204.17 / $302.00	Professional		$181.97	$204.17	$302.00
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $58.88 / $123.03	Professional	26	$58.88	$58.88	$123.03
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 / $363.08 / $616.60	Professional		$234.42	$363.08	$616.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $147.91	Professional	26	$51.29	$83.18	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $302.00 / $478.63	Professional	TC	$173.78	$302.00	$478.63