Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $72.44 / $93.33	Facility	26	$57.54	$72.44	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $398.11	Professional		$131.83	$186.21	$398.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $194.98	Professional	26	$51.29	$77.62	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $128.82 / $275.42	Professional	TC	$87.10	$128.82	$275.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $354.81	Professional		$181.97	$257.04	$354.81
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $79.43 / $109.65	Professional	26	$60.26	$79.43	$109.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $177.83 / $245.47	Professional	TC	$125.89	$177.83	$245.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $257.04 / $407.38	Professional		$158.49	$257.04	$407.38
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $81.28 / $138.04	Professional	26	$53.70	$81.28	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $177.83 / $269.15	Professional	TC	$104.71	$177.83	$269.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $977.24 / $977.24	Professional		$257.04	$977.24	$977.24
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $257.04 / $257.04	Professional	26	$77.62	$257.04	$257.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $724.44 / $724.44	Professional	TC	$177.83	$724.44	$724.44
Select Health Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $181.97 / $186.21	Professional		$165.96	$181.97	$186.21
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $54.95 / $56.23	Professional	26	$54.95	$54.95	$56.23
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $125.89 / $125.89	Professional	TC	$112.20	$125.89	$125.89
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $263.03 / $436.52	Professional		$162.18	$263.03	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $85.11 / $151.36	Professional	26	$50.12	$85.11	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $177.83 / $288.40	Professional	TC	$112.20	$177.83	$288.40