Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $154.88	Facility	26	$77.62	$77.62	$154.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $257.04 / $645.65	Professional		$190.55	$257.04	$645.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $89.13 / $177.83	Professional	26	$64.57	$89.13	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $162.18 / $338.84	Professional	TC	$125.89	$162.18	$338.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $302.00 / $724.44	Professional		$213.80	$302.00	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $100.00 / $147.91	Professional	26	$77.62	$100.00	$147.91
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $190.55 / $501.19	Professional	TC	$144.54	$190.55	$501.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $151.36 / $151.36 / $151.36	Facility	26	$151.36	$151.36	$151.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $309.03 / $645.65	Professional		$204.17	$309.03	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $91.20 / $177.83	Professional	26	$63.10	$91.20	$177.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $426.58	Professional	TC	$138.04	$204.17	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $354.81 / $1,621.81	Professional		$323.59	$354.81	$1,621.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $104.71 / $114.82	Professional	26	$104.71	$104.71	$114.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $213.80 / $239.88	Professional	TC	$213.80	$213.80	$239.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $229.09 / $338.84	Professional		$199.53	$229.09	$338.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $74.13 / $120.23	Professional	26	$74.13	$74.13	$120.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $151.36 / $223.87	Professional	TC	$144.54	$151.36	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $588.84 / $1,071.52	Professional		$263.03	$588.84	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $104.71 / $199.53	Professional	26	$67.61	$104.71	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $407.38 / $933.25	Professional	TC	$177.83	$407.38	$933.25