Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $158.49 / $158.49 / $251.19	Facility	26	$158.49	$158.49	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $870.96	Professional		$316.23	$457.09	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $158.49 / $389.05	Professional	26	$128.82	$158.49	$389.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $186.21 / $288.40 / $537.03	Professional	TC	$186.21	$288.40	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $630.96 / $933.25	Professional		$416.87	$630.96	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $208.93 / $302.00	Professional	26	$147.91	$208.93	$302.00
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $426.58 / $630.96	Professional	TC	$213.80	$426.58	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $616.60 / $912.01	Professional		$407.38	$616.60	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $229.09 / $354.81	Professional	26	$144.54	$229.09	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $389.05 / $602.56	Professional	TC	$245.47	$389.05	$602.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $758.58 / $2,238.72	Professional		$691.83	$758.58	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $245.47 / $954.99	Professional	26	$218.78	$245.47	$954.99
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $467.74 / $512.86 / $1,318.26	Professional	TC	$467.74	$512.86	$1,318.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $478.63 / $489.78	Professional		$416.87	$478.63	$489.78
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $154.88 / $154.88	Professional	26	$147.91	$154.88	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $331.13 / $331.13	Professional	TC	$281.84	$331.13	$331.13
United Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $588.84 / $977.24	Professional		$446.68	$588.84	$977.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $229.09 / $371.54	Professional	26	$190.55	$229.09	$371.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $346.74 / $616.60	Professional	TC	$257.04	$346.74	$616.60