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 $218.78 / $281.84 / $575.44	Professional		$218.78	$281.84	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $63.10 / $141.25	Professional	26	$52.48	$63.10	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $398.11	Professional	TC	$162.18	$218.78	$398.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $331.13 / $575.44	Professional		$251.19	$331.13	$575.44
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 $190.55 / $239.88 / $478.63	Professional	TC	$190.55	$239.88	$478.63
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $371.54 / $691.83	Professional		$223.87	$371.54	$691.83
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 $173.78 / $302.00 / $549.54	Professional	TC	$173.78	$302.00	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $398.11 / $1,621.81	Professional		$354.81	$398.11	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $89.13 / $257.04	Professional	26	$81.28	$89.13	$257.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $295.12 / $1,348.96	Professional	TC	$269.15	$295.12	$1,348.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $245.47 / $363.08	Professional		$218.78	$245.47	$363.08
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 $165.96 / $190.55 / $245.47	Professional	TC	$165.96	$190.55	$245.47
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $389.05 / $660.69	Professional		$263.03	$389.05	$660.69
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 $199.53 / $309.03 / $512.86	Professional	TC	$199.53	$309.03	$512.86