Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $61.66 / $79.43	Facility	26	$48.98	$61.66	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $218.78 / $467.74	Professional		$117.49	$218.78	$467.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $81.28 / $169.82	Professional	26	$40.74	$81.28	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $102.33 / $245.47	Professional	TC	$72.44	$102.33	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $199.53 / $275.42	Professional		$144.54	$199.53	$275.42
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $67.61 / $93.33	Professional	26	$48.98	$67.61	$93.33
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $181.97	Professional	TC	$95.50	$131.83	$181.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $338.84	Professional		$123.03	$162.18	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $117.49	Professional	26	$42.66	$56.23	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $104.71 / $229.09	Professional	TC	$79.43	$104.71	$229.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $234.42 / $588.84	Professional		$204.17	$234.42	$588.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $79.43 / $223.87	Professional	26	$67.61	$79.43	$223.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $154.88 / $363.08	Professional	TC	$134.90	$154.88	$363.08
Select Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $141.25 / $204.17	Professional		$134.90	$141.25	$204.17
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $47.86 / $74.13	Professional	26	$46.77	$47.86	$74.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $93.33 / $117.49	Professional	TC	$89.13	$93.33	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $186.21 / $302.00	Professional		$141.25	$186.21	$302.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $64.57 / $107.15	Professional	26	$48.98	$64.57	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $120.23 / $199.53	Professional	TC	$91.20	$120.23	$199.53