Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $52.48 / $69.18	Facility	26	$41.69	$52.48	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $181.97 / $407.38	Professional		$93.33	$181.97	$407.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $67.61 / $169.82	Professional	26	$34.67	$67.61	$169.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $79.43 / $204.17	Professional	TC	$56.23	$79.43	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $223.87	Professional		$114.82	$158.49	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $57.54 / $79.43	Professional	26	$41.69	$57.54	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $100.00 / $144.54	Professional	TC	$74.13	$100.00	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $125.89 / $269.15	Professional		$93.33	$125.89	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $48.98 / $100.00	Professional	26	$36.31	$48.98	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $77.62 / $169.82	Professional	TC	$57.54	$77.62	$169.82
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $190.55 / $416.87	Professional		$151.36	$190.55	$416.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $69.18 / $194.98	Professional	26	$58.88	$69.18	$194.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $123.03 / $229.09	Professional	TC	$107.15	$123.03	$229.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $151.36	Professional		$109.65	$117.49	$151.36
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $63.10	Professional	26	$39.81	$41.69	$63.10
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $74.13 / $93.33	Professional	TC	$66.07	$74.13	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $147.91 / $245.47	Professional		$109.65	$147.91	$245.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $93.33	Professional	26	$42.66	$56.23	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $93.33 / $154.88	Professional	TC	$69.18	$93.33	$154.88