Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.12 / $25.12 / $47.86	Facility	26	$25.12	$25.12	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $380.19	Professional		$144.54	$177.83	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $25.70 / $58.88	Professional	26	$21.88	$25.70	$58.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $151.36 / $323.59	Professional	TC	$123.03	$151.36	$323.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $165.96 / $223.87	Professional		$165.96	$165.96	$223.87
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $23.99 / $35.48	Professional	26	$23.99	$23.99	$35.48
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $141.25 / $199.53	Professional	TC	$141.25	$141.25	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $416.87	Professional		$165.96	$245.47	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $33.88 / $60.26	Professional	26	$25.12	$33.88	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $213.80 / $363.08	Professional	TC	$147.91	$213.80	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $691.83	Professional		$245.47	$288.40	$691.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $38.90 / $91.20	Professional	26	$33.88	$38.90	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $245.47 / $602.56	Professional	TC	$213.80	$245.47	$602.56
Select Health Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $281.84	Professional		$162.18	$173.78	$281.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $23.99 / $42.66	Professional	26	$22.91	$23.99	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $138.04 / $151.36 / $239.88	Professional	TC	$138.04	$151.36	$239.88
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $380.19	Professional		$165.96	$251.19	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $34.67 / $54.95	Professional	26	$24.55	$34.67	$54.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $218.78 / $323.59	Professional	TC	$141.25	$218.78	$323.59