Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $81.28	Facility	26	$52.48	$52.48	$81.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $104.71 / $239.88	Professional		$83.18	$104.71	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $60.26 / $144.54	Professional	26	$41.69	$60.26	$144.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $97.72	Professional	TC	$38.90	$52.48	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $194.98	Professional		$97.72	$131.83	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $69.18 / $97.72	Professional	26	$51.29	$69.18	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $104.71	Professional	TC	$46.77	$64.57	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $151.36 / $239.88	Professional		$89.13	$151.36	$239.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $75.86 / $117.49	Professional	26	$47.86	$75.86	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $74.13 / $125.89	Professional	TC	$42.66	$74.13	$125.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $851.14	Professional		$141.25	$154.88	$851.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $79.43 / $371.54	Professional	26	$72.44	$79.43	$371.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $74.13 / $489.78	Professional	TC	$67.61	$74.13	$489.78
Select Health Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $97.72 / $97.72	Professional		$89.13	$97.72	$97.72
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $51.29 / $51.29	Professional	26	$48.98	$51.29	$51.29
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $47.86 / $47.86	Professional	TC	$40.74	$47.86	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $162.18 / $239.88	Professional		$120.23	$162.18	$239.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $123.03	Professional	26	$56.23	$75.86	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $134.90	Professional	TC	$56.23	$81.28	$134.90