Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $93.33 / $812.83	Professional		$61.66	$93.33	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $257.04 / $741.31	Professional	26	$18.62	$257.04	$741.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $63.10 / $93.33	Professional	TC	$36.31	$63.10	$93.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $208.93	Professional		$123.03	$123.03	$208.93
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $28.84 / $48.98	Professional	26	$28.84	$28.84	$48.98
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $93.33 / $162.18	Professional	TC	$93.33	$93.33	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $72.44 / $177.83	Professional		$32.36	$72.44	$177.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $20.89 / $46.77	Professional	26	$12.88	$20.89	$46.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $46.77 / $120.23	Professional	TC	$19.50	$46.77	$120.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $158.49 / $158.49	Professional		$158.49	$158.49	$158.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Professional	26	$38.90	$38.90	$38.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $117.49 / $117.49 / $117.49	Professional	TC	$117.49	$117.49	$117.49
Select Health Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $112.20 / $181.97	Professional		$100.00	$112.20	$181.97
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $28.18 / $47.86	Professional	26	$26.30	$28.18	$47.86
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $85.11 / $131.83	Professional	TC	$72.44	$85.11	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $67.61 / $177.83	Professional		$43.65	$67.61	$177.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.60 / $18.20 / $57.54	Professional	26	$16.60	$18.20	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $51.29 / $120.23	Professional	TC	$26.30	$51.29	$120.23