Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $52.48 / $67.61	Facility	26	$40.74	$52.48	$67.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $288.40 / $602.56	Professional		$208.93	$288.40	$602.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $46.77 / $102.33	Professional	26	$34.67	$46.77	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $239.88 / $549.54	Professional	TC	$177.83	$239.88	$549.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $562.34	Professional		$288.40	$398.11	$562.34
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $57.54 / $79.43	Professional	26	$42.66	$57.54	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $338.84 / $489.78	Professional	TC	$234.42	$338.84	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $371.54 / $630.96	Professional		$208.93	$371.54	$630.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $57.54 / $97.72	Professional	26	$38.90	$57.54	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $309.03 / $575.44	Professional	TC	$173.78	$309.03	$575.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $954.99 / $954.99	Professional		$389.05	$954.99	$954.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $199.53 / $199.53	Professional	26	$56.23	$199.53	$199.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $741.31 / $741.31	Professional	TC	$331.13	$741.31	$741.31
Select Health Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $275.42 / $288.40	Professional		$263.03	$275.42	$288.40
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $39.81 / $40.74	Professional	26	$38.90	$39.81	$40.74
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $234.42 / $251.19	Professional	TC	$223.87	$234.42	$251.19
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $416.87 / $724.44	Professional		$204.17	$416.87	$724.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $61.66 / $109.65	Professional	26	$35.48	$61.66	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $354.81 / $630.96	Professional	TC	$169.82	$354.81	$630.96