Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $40.74 / $63.10	Facility	26	$39.81	$40.74	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $275.42 / $575.44	Professional		$223.87	$275.42	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $39.81 / $87.10	Professional	26	$33.88	$39.81	$87.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $234.42 / $371.54	Professional	TC	$190.55	$234.42	$371.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $323.59	Professional		$263.03	$263.03	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $38.02 / $43.65	Professional	26	$38.02	$38.02	$43.65
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $223.87 / $281.84	Professional	TC	$223.87	$223.87	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $363.08 / $616.60	Professional		$257.04	$363.08	$616.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.48 / $89.13	Professional	26	$38.90	$52.48	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $309.03 / $524.81	Professional	TC	$218.78	$309.03	$524.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $436.52 / $1,023.29	Professional		$371.54	$436.52	$1,023.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $57.54 / $61.66	Professional	26	$52.48	$57.54	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $316.23 / $346.74 / $371.54	Professional	TC	$316.23	$346.74	$371.54
Select Health Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $263.03 / $389.05	Professional		$234.42	$263.03	$389.05
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $37.15 / $69.18	Professional	26	$36.31	$37.15	$69.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $223.87 / $363.08	Professional	TC	$208.93	$223.87	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $371.54 / $588.84	Professional		$257.04	$371.54	$588.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $53.70 / $87.10	Professional	26	$38.90	$53.70	$87.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $316.23 / $501.19	Professional	TC	$223.87	$316.23	$501.19