Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.33 / $117.49 / $144.54	Facility	26	$93.33	$117.49	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $169.82 / $309.03	Professional		$134.90	$169.82	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $89.13 / $173.78	Professional	26	$57.54	$89.13	$173.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $79.43 / $218.78	Professional	TC	$57.54	$79.43	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $229.09 / $380.19	Professional		$169.82	$229.09	$380.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $114.82 / $177.83	Professional	26	$87.10	$114.82	$177.83
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $77.62 / $104.71 / $218.78	Professional	TC	$77.62	$104.71	$218.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $245.47 / $512.86	Professional		$151.36	$245.47	$512.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $97.72 / $194.98	Professional	26	$60.26	$97.72	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $134.90 / $371.54	Professional	TC	$67.61	$134.90	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $263.03 / $891.25	Professional		$239.88	$263.03	$891.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $141.25 / $186.21	Professional	26	$128.82	$141.25	$186.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $120.23 / $707.95	Professional	TC	$109.65	$120.23	$707.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $165.96 / $251.19	Professional		$158.49	$165.96	$251.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $91.20 / $144.54	Professional	26	$89.13	$91.20	$144.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $77.62 / $107.15	Professional	TC	$67.61	$77.62	$107.15
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $309.03 / $537.03	Professional		$177.83	$309.03	$537.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $109.65 / $204.17	Professional	26	$63.10	$109.65	$204.17
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $165.96 / $346.74	Professional	TC	$81.28	$165.96	$346.74