Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $234.42 / $302.00 / $389.05	Facility	26	$234.42	$302.00	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $501.19 / $1,148.15	Professional		$426.58	$501.19	$1,148.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $190.55 / $316.23 / $645.65	Professional	26	$190.55	$316.23	$645.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $269.15 / $512.86	Professional	TC	$218.78	$269.15	$512.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $489.78 / $660.69 / $933.25	Professional		$489.78	$660.69	$933.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $234.42 / $309.03 / $446.68	Professional	26	$234.42	$309.03	$446.68
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $346.74 / $489.78	Professional	TC	$251.19	$346.74	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $724.44 / $1,148.15	Professional		$457.09	$724.44	$1,148.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $213.80 / $338.84 / $524.81	Professional	26	$213.80	$338.84	$524.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $389.05 / $645.65	Professional	TC	$245.47	$389.05	$645.65
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $707.95 / $776.25 / $2,238.72	Professional		$707.95	$776.25	$2,238.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $331.13 / $363.08 / $1,047.13	Professional	26	$331.13	$363.08	$1,047.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $416.87 / $1,174.90	Professional	TC	$380.19	$416.87	$1,174.90
Select Health Facility/Professional Professional Modifier Low / Median / High Price $446.68 / $501.19 / $501.19	Professional		$446.68	$501.19	$501.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $218.78 / $229.09 / $229.09	Professional	26	$218.78	$229.09	$229.09
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $263.03 / $263.03	Professional	TC	$223.87	$263.03	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $724.44 / $1,174.90	Professional		$602.56	$724.44	$1,174.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $281.84 / $338.84 / $549.54	Professional	26	$281.84	$338.84	$549.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $380.19 / $602.56	Professional	TC	$316.23	$380.19	$602.56