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 / $85.11	Facility	26	$50.12	$64.57	$85.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $363.08 / $676.08	Professional		$269.15	$363.08	$676.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $53.70 / $131.83	Professional	26	$41.69	$53.70	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $309.03 / $588.84	Professional	TC	$234.42	$309.03	$588.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $724.44	Professional		$380.19	$512.86	$724.44
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $70.79 / $97.72	Professional	26	$53.70	$70.79	$97.72
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $446.68 / $630.96	Professional	TC	$316.23	$446.68	$630.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $501.19 / $812.83	Professional		$295.12	$501.19	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $72.44 / $120.23	Professional	26	$48.98	$72.44	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $416.87 / $691.83	Professional	TC	$245.47	$416.87	$691.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $2,951.21 / $2,951.21	Professional		$501.19	$2,951.21	$2,951.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $446.68 / $446.68	Professional	26	$70.79	$446.68	$446.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $436.52 / $2,511.89 / $2,511.89	Professional	TC	$436.52	$2,511.89	$2,511.89
Select Health Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $354.81 / $380.19	Professional		$338.84	$354.81	$380.19
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $50.12 / $50.12	Professional	26	$48.98	$50.12	$50.12
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $302.00 / $323.59	Professional	TC	$288.40	$302.00	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $549.54 / $954.99	Professional		$295.12	$549.54	$954.99
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 $251.19 / $467.74 / $812.83	Professional	TC	$251.19	$467.74	$812.83