Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $257.04	Professional		$67.61	$95.50	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $28.18 / $54.95	Professional	26	$19.95	$28.18	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $204.17	Professional	TC	$47.86	$67.61	$204.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $229.09	Professional		$120.23	$120.23	$229.09
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $33.11 / $64.57	Professional	26	$33.11	$33.11	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $85.11 / $165.96	Professional	TC	$85.11	$85.11	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $104.71 / $309.03	Professional		$52.48	$104.71	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $29.51 / $89.13	Professional	26	$15.85	$29.51	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $77.62 / $186.21	Professional	TC	$37.15	$77.62	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $154.88	Professional		$154.88	$154.88	$154.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	26	$44.67	$44.67	$44.67
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 $97.72 / $109.65 / $177.83	Professional		$97.72	$109.65	$177.83
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $31.62 / $54.95	Professional	26	$30.20	$31.62	$54.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $77.62 / $123.03	Professional	TC	$67.61	$77.62	$123.03
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $131.83 / $263.03	Professional		$67.61	$131.83	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $36.31 / $81.28	Professional	26	$19.05	$36.31	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $97.72 / $181.97	Professional	TC	$47.86	$97.72	$181.97