Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $245.47 / $831.76	Facility		$102.33	$245.47	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.92 / $34.67 / $52.48	Facility	26	$26.92	$34.67	$52.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $131.83 / $309.03	Professional		$72.44	$131.83	$309.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $36.31 / $89.13	Professional	26	$24.55	$36.31	$89.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $93.33 / $173.78	Professional	TC	$50.12	$93.33	$173.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $398.11 / $630.96	Facility		$288.40	$398.11	$630.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $169.82 / $239.88	Professional		$123.03	$169.82	$239.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $38.02 / $52.48	Professional	26	$28.18	$38.02	$52.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $131.83 / $186.21	Professional	TC	$95.50	$131.83	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $125.89	Facility		$117.49	$117.49	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $213.80	Professional		$61.66	$109.65	$213.80
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $25.70 / $53.70	Professional	26	$23.99	$25.70	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $75.86 / $162.18	Professional	TC	$38.02	$75.86	$162.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $181.97 / $524.81	Professional		$177.83	$181.97	$524.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $177.83	Professional	26	$38.90	$38.90	$177.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $141.25 / $346.74	Professional	TC	$141.25	$141.25	$346.74
Select Health Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $128.82	Professional		$112.20	$128.82	$128.82
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $27.54 / $27.54	Professional	26	$25.70	$27.54	$27.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $100.00 / $100.00	Professional	TC	$85.11	$100.00	$100.00
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $134.90 / $257.04	Professional		$70.79	$134.90	$257.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $37.15 / $61.66	Professional	26	$26.92	$37.15	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $97.72 / $181.97	Professional	TC	$43.65	$97.72	$181.97