Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	26	$67.61	$67.61	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $275.42 / $549.54	Professional		$218.78	$275.42	$549.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $67.61 / $117.49	Professional	26	$52.48	$67.61	$117.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $213.80 / $436.52	Professional	TC	$158.49	$213.80	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $331.13 / $524.81	Professional		$234.42	$331.13	$524.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $85.11 / $120.23	Professional	26	$58.88	$85.11	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $239.88 / $436.52	Professional	TC	$169.82	$239.88	$436.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $426.58 / $645.65	Professional		$218.78	$426.58	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $87.10 / $144.54	Professional	26	$53.70	$87.10	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $309.03 / $549.54	Professional	TC	$158.49	$309.03	$549.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $363.08 / $1,819.70	Professional		$331.13	$363.08	$1,819.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $95.50 / $288.40	Professional	26	$87.10	$95.50	$288.40
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $269.15 / $1,513.56	Professional	TC	$245.47	$269.15	$1,513.56
Select Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $234.42 / $234.42	Professional		$213.80	$234.42	$234.42
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $61.66 / $63.10	Professional	26	$60.26	$61.66	$63.10
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $169.82 / $173.78	Professional	TC	$154.88	$169.82	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $758.58	Professional		$281.84	$426.58	$758.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $95.50 / $154.88	Professional	26	$48.98	$95.50	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $316.23 / $588.84	Professional	TC	$204.17	$316.23	$588.84