Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.02 / $38.02 / $38.02	Facility	26	$38.02	$38.02	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $141.25 / $275.42	Professional		$104.71	$141.25	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $30.90 / $81.28	Professional	26	$22.91	$30.90	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $109.65 / $177.83	Professional	TC	$74.13	$109.65	$177.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $181.97	Professional		$141.25	$169.82	$181.97
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $25.12 / $38.90	Professional	26	$25.12	$25.12	$38.90
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $144.54 / $144.54	Professional	TC	$97.72	$144.54	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $239.88 / $416.87	Professional		$162.18	$239.88	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.90 / $66.07	Professional	26	$27.54	$38.90	$66.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $204.17 / $346.74	Professional	TC	$138.04	$204.17	$346.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $245.47 / $489.78	Professional		$213.80	$245.47	$489.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $60.26 / $83.18	Professional	26	$52.48	$60.26	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $186.21 / $407.38	Professional	TC	$162.18	$186.21	$407.38
Select Health Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $151.36 / $288.40	Professional		$138.04	$151.36	$288.40
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $37.15 / $58.88	Professional	26	$25.12	$37.15	$58.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $114.82 / $218.78	Professional	TC	$112.20	$114.82	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $363.08	Professional		$165.96	$245.47	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $38.90 / $58.88	Professional	26	$26.92	$38.90	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $208.93 / $309.03	Professional	TC	$138.04	$208.93	$309.03