Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $91.20 / $117.49	Facility	26	$75.86	$91.20	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $173.78 / $371.54	Professional		$131.83	$173.78	$371.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $199.53	Professional	26	$54.95	$85.11	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $95.50 / $218.78	Professional	TC	$64.57	$95.50	$218.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $194.98 / $295.12	Professional		$134.90	$194.98	$295.12
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $91.20 / $138.04	Professional	26	$61.66	$91.20	$138.04
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $158.49	Professional	TC	$69.18	$104.71	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $141.25	Facility	26	$74.13	$74.13	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $177.83 / $371.54	Professional		$120.23	$177.83	$371.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $74.13 / $144.54	Professional	26	$51.29	$74.13	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $100.00 / $239.88	Professional	TC	$61.66	$100.00	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $190.55 / $831.76	Professional		$177.83	$190.55	$831.76
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $107.15 / $125.89	Professional	26	$95.50	$107.15	$125.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $93.33 / $707.95	Professional	TC	$83.18	$93.33	$707.95
Select Health Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $194.98	Professional		$125.89	$125.89	$194.98
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $67.61 / $109.65	Professional	26	$67.61	$67.61	$109.65
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $58.88 / $87.10	Professional	TC	$58.88	$58.88	$87.10
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $223.87 / $371.54	Professional		$131.83	$223.87	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $89.13 / $162.18	Professional	26	$48.98	$89.13	$162.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $120.23 / $234.42	Professional	TC	$70.79	$120.23	$234.42