Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $85.11 / $104.71 / $104.71	Facility	26	$85.11	$104.71	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $165.96 / $275.42	Professional		$128.82	$165.96	$275.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $85.11 / $229.09	Professional	26	$72.44	$85.11	$229.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $83.18 / $128.82	Professional	TC	$57.54	$83.18	$128.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $218.78 / $323.59	Professional		$151.36	$218.78	$323.59
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $109.65 / $162.18	Professional	26	$81.28	$109.65	$162.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $112.20 / $165.96	Professional	TC	$67.61	$112.20	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $234.42 / $354.81	Professional		$147.91	$234.42	$354.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.10 / $120.23 / $173.78	Professional	26	$87.10	$120.23	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $120.23 / $181.97	Professional	TC	$52.48	$120.23	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $239.88 / $6,760.83	Professional		$169.82	$239.88	$6,760.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $117.49 / $5,011.87	Professional	26	$83.18	$117.49	$5,011.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $123.03 / $1,778.28	Professional	TC	$85.11	$123.03	$1,778.28
Select Health Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $169.82 / $199.53	Professional		$154.88	$169.82	$199.53
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $83.18 / $128.82	Professional	26	$77.62	$83.18	$128.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $85.11 / $93.33	Professional	TC	$75.86	$85.11	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $218.78 / $380.19	Professional		$144.54	$218.78	$380.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $112.20 / $181.97	Professional	26	$81.28	$112.20	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $112.20 / $194.98	Professional	TC	$51.29	$112.20	$194.98