Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $154.88	Professional		$72.44	$100.00	$154.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $48.98 / $194.98	Professional	26	$28.18	$48.98	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $63.10 / $100.00	Professional	TC	$45.71	$63.10	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $123.03 / $213.80	Professional		$123.03	$123.03	$213.80
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $43.65 / $75.86	Professional	26	$43.65	$43.65	$75.86
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $79.43 / $138.04	Professional	TC	$79.43	$79.43	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $95.50 / $229.09	Professional		$58.88	$95.50	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $36.31 / $93.33	Professional	26	$20.42	$36.31	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $60.26 / $144.54	Professional	TC	$37.15	$60.26	$144.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $169.82	Professional		$169.82	$169.82	$169.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	26	$57.54	$57.54	$57.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	TC	$109.65	$109.65	$109.65
Select Health Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $120.23 / $190.55	Professional		$107.15	$120.23	$190.55
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $74.13	Professional	26	$39.81	$41.69	$74.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $79.43 / $120.23	Professional	TC	$67.61	$79.43	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $93.33 / $288.40	Professional		$70.79	$93.33	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $35.48 / $107.15	Professional	26	$25.12	$35.48	$107.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $58.88 / $173.78	Professional	TC	$46.77	$58.88	$173.78