Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $63.10 / $81.28 / $104.71	Facility	26	$63.10	$81.28	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $524.81	Professional		$120.23	$154.88	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $169.82 / $870.96	Professional	26	$57.54	$169.82	$870.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $83.18 / $165.96	Professional	TC	$60.26	$83.18	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $251.19	Professional		$131.83	$177.83	$251.19
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $83.18 / $120.23	Professional	26	$63.10	$83.18	$120.23
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $95.50 / $154.88	Professional	TC	$69.18	$95.50	$154.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $199.53 / $309.03	Professional		$120.23	$199.53	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $91.20 / $144.54	Professional	26	$57.54	$91.20	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $114.82 / $186.21	Professional	TC	$63.10	$114.82	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $204.17 / $707.95	Professional		$186.21	$204.17	$707.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $95.50 / $295.12	Professional	26	$87.10	$95.50	$295.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $109.65 / $416.87	Professional	TC	$100.00	$109.65	$416.87
Select Health Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $131.83 / $131.83	Professional		$117.49	$131.83	$131.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $61.66 / $61.66	Professional	26	$58.88	$61.66	$61.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $70.79 / $70.79	Professional	TC	$60.26	$70.79	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $213.80 / $323.59	Professional		$165.96	$213.80	$323.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $91.20 / $147.91	Professional	26	$74.13	$91.20	$147.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $120.23 / $169.82	Professional	TC	$89.13	$120.23	$169.82