Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $74.13 / $93.33	Facility	26	$60.26	$74.13	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $194.98 / $426.58	Professional		$117.49	$194.98	$426.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $83.18 / $181.97	Professional	26	$51.29	$83.18	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $173.78 / $302.00	Professional	TC	$112.20	$173.78	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $275.42 / $478.63	Professional		$181.97	$275.42	$478.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $107.15	Professional	26	$57.54	$74.13	$107.15
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $173.78 / $346.74	Professional	TC	$125.89	$173.78	$346.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $112.20 / $112.20 / $112.20	Facility	26	$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $281.84 / $524.81	Professional		$158.49	$281.84	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $134.90	Professional	26	$46.77	$67.61	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $204.17 / $389.05	Professional	TC	$109.65	$204.17	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $346.74 / $1,071.52	Professional		$245.47	$346.74	$1,071.52
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $85.11 / $218.78	Professional	26	$77.62	$85.11	$218.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $186.21 / $870.96	Professional	TC	$169.82	$186.21	$870.96
Select Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $173.78 / $257.04	Professional		$154.88	$173.78	$257.04
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $53.70 / $112.20	Professional	26	$53.70	$53.70	$112.20
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $120.23 / $144.54	Professional	TC	$112.20	$120.23	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $295.12 / $489.78	Professional		$194.98	$295.12	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $75.86 / $134.90	Professional	26	$47.86	$75.86	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $229.09 / $380.19	Professional	TC	$141.25	$229.09	$380.19