Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.26 / $72.44 / $95.50	Facility	26	$60.26	$72.44	$95.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $389.05 / $724.44	Professional		$302.00	$389.05	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $66.07 / $181.97	Professional	26	$51.29	$66.07	$181.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $323.59 / $562.34	Professional	TC	$251.19	$323.59	$562.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $501.19 / $776.25	Professional		$309.03	$501.19	$776.25
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $75.86 / $112.20	Professional	26	$56.23	$75.86	$112.20
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $436.52 / $676.08	Professional	TC	$263.03	$436.52	$676.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $537.03 / $812.83	Professional		$302.00	$537.03	$812.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $83.18 / $117.49	Professional	26	$58.88	$83.18	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $446.68 / $676.08	Professional	TC	$229.09	$446.68	$676.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $616.60 / $1,096.48	Professional		$436.52	$616.60	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $81.28 / $354.81	Professional	26	$57.54	$81.28	$354.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $380.19 / $537.03 / $758.58	Professional	TC	$380.19	$537.03	$758.58
Select Health Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $602.56	Professional		$380.19	$436.52	$602.56
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $57.54 / $89.13	Professional	26	$54.95	$57.54	$89.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $380.19 / $467.74	Professional	TC	$331.13	$380.19	$467.74
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $467.74 / $812.83	Professional		$281.84	$467.74	$812.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $79.43 / $128.82	Professional	26	$57.54	$79.43	$128.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $213.80 / $398.11 / $691.83	Professional	TC	$213.80	$398.11	$691.83