Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $45.71 / $45.71 / $45.71	Facility	26	$45.71	$45.71	$45.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $295.12	Professional		$120.23	$151.36	$295.12
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $48.98 / $120.23	Professional	26	$38.90	$48.98	$120.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $104.71 / $186.21	Professional	TC	$81.28	$104.71	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $302.00	Professional		$154.88	$208.93	$302.00
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $63.10 / $91.20	Professional	26	$48.98	$63.10	$91.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $141.25 / $208.93	Professional	TC	$107.15	$141.25	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $380.19	Professional		$147.91	$208.93	$380.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $64.57 / $120.23	Professional	26	$47.86	$64.57	$120.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $144.54 / $263.03	Professional	TC	$100.00	$144.54	$263.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $239.88 / $660.69	Professional		$204.17	$239.88	$660.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $186.21	Professional	26	$63.10	$72.44	$186.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $165.96 / $478.63	Professional	TC	$144.54	$165.96	$478.63
Select Health Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $144.54 / $208.93	Professional		$134.90	$144.54	$208.93
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $43.65 / $67.61	Professional	26	$41.69	$43.65	$67.61
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $100.00 / $141.25	Professional	TC	$93.33	$100.00	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $204.17 / $338.84	Professional		$141.25	$204.17	$338.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $63.10 / $100.00	Professional	26	$45.71	$63.10	$100.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $141.25 / $218.78	Professional	TC	$95.50	$141.25	$218.78