Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.12 / $64.57 / $83.18	Facility	26	$50.12	$64.57	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $316.23 / $524.81	Professional		$234.42	$316.23	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $58.88 / $138.04	Professional	26	$41.69	$58.88	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $194.98 / $263.03 / $457.09	Professional	TC	$194.98	$263.03	$457.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $446.68 / $630.96	Professional		$323.59	$446.68	$630.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $70.79 / $97.72	Professional	26	$50.12	$70.79	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $380.19 / $537.03	Professional	TC	$269.15	$380.19	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $436.52 / $794.33	Professional		$302.00	$436.52	$794.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $120.23	Professional	26	$46.77	$70.79	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $676.08	Professional	TC	$257.04	$371.54	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $1,737.80 / $1,737.80	Professional		$436.52	$1,737.80	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $275.42 / $275.42	Professional	26	$69.18	$275.42	$275.42
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $1,445.44 / $1,445.44	Professional	TC	$363.08	$1,445.44	$1,445.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $309.03 / $323.59	Professional		$295.12	$309.03	$323.59
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $48.98 / $50.12	Professional	26	$47.86	$48.98	$50.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $257.04 / $275.42	Professional	TC	$245.47	$257.04	$275.42
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $812.83	Professional		$288.40	$489.78	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $75.86 / $134.90	Professional	26	$44.67	$75.86	$134.90
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $407.38 / $691.83	Professional	TC	$245.47	$407.38	$691.83