Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.49 / $89.13 / $138.04	Facility	26	$15.49	$89.13	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $691.83	Professional		$213.80	$295.12	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $97.72 / $275.42	Professional	26	$77.62	$97.72	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $173.78 / $354.81	Professional	TC	$138.04	$173.78	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $467.74	Professional		$263.03	$338.84	$467.74
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $120.23 / $169.82	Professional	26	$91.20	$120.23	$169.82
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $218.78 / $309.03	Professional	TC	$165.96	$218.78	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $346.74 / $645.65	Professional		$257.04	$346.74	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $229.09	Professional	26	$89.13	$123.03	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $218.78 / $426.58	Professional	TC	$162.18	$218.78	$426.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $407.38 / $660.69	Professional		$346.74	$407.38	$660.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $138.04 / $213.80	Professional	26	$117.49	$138.04	$213.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $269.15 / $457.09	Professional	TC	$229.09	$269.15	$457.09
Select Health Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $245.47 / $354.81	Professional		$229.09	$245.47	$354.81
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $83.18 / $128.82	Professional	26	$79.43	$83.18	$128.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $162.18 / $223.87	Professional	TC	$151.36	$162.18	$223.87
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $338.84 / $549.54	Professional		$239.88	$338.84	$549.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $123.03 / $199.53	Professional	26	$87.10	$123.03	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $346.74	Professional	TC	$151.36	$213.80	$346.74