Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $28.18 / $28.18	Facility	26	$28.18	$28.18	$28.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $91.20 / $134.90	Professional		$70.79	$91.20	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $63.10 / $91.20	Professional	TC	$46.77	$63.10	$91.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $181.97	Professional		$91.20	$125.89	$181.97
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $87.10 / $128.82	Professional	TC	$60.26	$87.10	$128.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $213.80	Professional		$79.43	$117.49	$213.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $83.18 / $151.36	Professional	TC	$52.48	$83.18	$151.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $229.09	Professional		$128.82	$144.54	$229.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $42.66 / $87.10	Professional	26	$38.90	$42.66	$87.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $97.72 / $141.25	Professional	TC	$89.13	$97.72	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $91.20 / $134.90	Professional		$85.11	$91.20	$134.90
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $63.10 / $91.20	Professional	TC	$58.88	$63.10	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $223.87	Professional		$93.33	$131.83	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $97.72 / $154.88	Professional	TC	$60.26	$97.72	$154.88