Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $112.20 / $144.54	Facility	26	$91.20	$112.20	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $436.52 / $812.83	Professional		$338.84	$436.52	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $95.50 / $275.42	Professional	26	$79.43	$95.50	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $354.81 / $537.03	Professional	TC	$269.15	$354.81	$537.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $562.34 / $870.96	Professional		$354.81	$562.34	$870.96
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $114.82 / $165.96	Professional	26	$85.11	$114.82	$165.96
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $467.74 / $707.95	Professional	TC	$288.40	$467.74	$707.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $616.60 / $933.25	Professional		$380.19	$616.60	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $128.82 / $181.97	Professional	26	$93.33	$128.82	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $288.40 / $489.78 / $724.44	Professional	TC	$288.40	$489.78	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $501.19 / $724.44 / $4,265.80	Professional		$501.19	$724.44	$4,265.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $128.82 / $1,513.56	Professional	26	$91.20	$128.82	$1,513.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $588.84 / $2,691.53	Professional	TC	$416.87	$588.84	$2,691.53
Select Health Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $575.44	Professional		$436.52	$501.19	$575.44
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $91.20 / $95.50	Professional	26	$83.18	$91.20	$95.50
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $416.87 / $489.78	Professional	TC	$363.08	$416.87	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $537.03 / $912.01	Professional		$363.08	$537.03	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $194.98	Professional	26	$89.13	$123.03	$194.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $426.58 / $741.31	Professional	TC	$263.03	$426.58	$741.31