Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $58.88 / $162.18	Facility	26	$40.74	$58.88	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $190.55 / $478.63	Professional		$131.83	$190.55	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $63.10 / $177.83	Professional	26	$36.31	$63.10	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $125.89 / $269.15	Professional	TC	$97.72	$125.89	$269.15
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 $38.02 / $38.02 / $64.57	Professional	26	$38.02	$38.02	$64.57
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $128.82 / $128.82 / $162.18	Professional	TC	$128.82	$128.82	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $251.19 / $416.87	Professional		$173.78	$251.19	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $64.57 / $104.71	Professional	26	$41.69	$64.57	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $186.21 / $302.00	Professional	TC	$131.83	$186.21	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $257.04 / $467.74	Professional		$213.80	$257.04	$467.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $131.83	Professional	26	$53.70	$61.66	$131.83
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $186.21 / $338.84	Professional	TC	$162.18	$186.21	$338.84
Select Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $151.36 / $281.84	Professional		$147.91	$151.36	$281.84
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $38.02 / $69.18	Professional	26	$36.31	$38.02	$69.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $114.82 / $208.93	Professional	TC	$112.20	$114.82	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $245.47 / $371.54	Professional		$165.96	$245.47	$371.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $66.07 / $97.72	Professional	26	$40.74	$66.07	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $125.89 / $186.21 / $281.84	Professional	TC	$125.89	$186.21	$281.84