Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $338.84 / $660.69	Professional		$257.04	$338.84	$660.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $245.47 / $954.99	Professional	26	$104.71	$245.47	$954.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $223.87 / $371.54	Professional	TC	$173.78	$223.87	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $457.09 / $794.33	Professional		$457.09	$457.09	$794.33
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $144.54 / $144.54 / $251.19	Professional	26	$144.54	$144.54	$251.19
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $316.23 / $537.03	Professional	TC	$316.23	$316.23	$537.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $288.40 / $724.44	Professional		$141.25	$288.40	$724.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $123.03 / $323.59	Professional	26	$61.66	$123.03	$323.59
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $177.83 / $489.78	Professional	TC	$79.43	$177.83	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Professional		$602.56	$602.56	$602.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $194.98 / $194.98 / $194.98	Professional	26	$194.98	$194.98	$194.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $416.87 / $416.87	Professional	TC	$416.87	$416.87	$416.87
Select Health Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $436.52 / $707.95	Professional		$389.05	$436.52	$707.95
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $131.83 / $138.04 / $239.88	Professional	26	$131.83	$138.04	$239.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $467.74	Professional	TC	$257.04	$295.12	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $851.14	Professional		$177.83	$257.04	$851.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $91.20 / $302.00	Professional	26	$77.62	$91.20	$302.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $173.78 / $549.54	Professional	TC	$100.00	$173.78	$549.54