Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.86 / $48.98 / $75.86	Facility	26	$47.86	$48.98	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $131.83 / $446.68	Professional		$83.18	$131.83	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $66.07 / $190.55	Professional	26	$41.69	$66.07	$190.55
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $416.87 / $575.44	Professional	50	$181.97	$416.87	$575.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $53.70 / $85.11	Professional	TC	$39.81	$53.70	$85.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $125.89 / $194.98	Professional		$87.10	$125.89	$194.98
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $58.88 / $89.13	Professional	26	$44.67	$58.88	$89.13
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $42.66 / $67.61 / $109.65	Professional	TC	$42.66	$67.61	$109.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $199.53	Professional		$102.33	$141.25	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $69.18 / $97.72	Professional	26	$50.12	$69.18	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $72.44 / $107.15	Professional	TC	$48.98	$72.44	$107.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $147.91 / $407.38	Professional		$104.71	$147.91	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $66.07 / $218.78	Professional	26	$46.77	$66.07	$218.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $83.18 / $186.21	Professional	TC	$57.54	$83.18	$186.21
Select Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $104.71 / $112.20	Professional		$93.33	$104.71	$112.20
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $46.77 / $64.57	Professional	26	$43.65	$46.77	$64.57
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $57.54 / $57.54	Professional	TC	$50.12	$57.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $134.90 / $213.80	Professional		$93.33	$134.90	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $67.61 / $102.33	Professional	26	$46.77	$67.61	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $66.07 / $112.20	Professional	TC	$46.77	$66.07	$112.20