Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.84 / $28.84 / $28.84	Facility	26	$28.84	$28.84	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $158.49 / $204.17	Professional		$125.89	$158.49	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $131.83 / $169.82	Professional	TC	$100.00	$131.83	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $218.78 / $338.84	Professional		$134.90	$218.78	$338.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $107.15 / $186.21 / $288.40	Professional	TC	$107.15	$186.21	$288.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $213.80 / $354.81	Professional		$144.54	$213.80	$354.81
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $177.83 / $288.40	Professional	TC	$109.65	$177.83	$288.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $257.04 / $741.31	Professional		$177.83	$257.04	$741.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.90 / $338.84	Professional	26	$27.54	$38.90	$338.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $213.80 / $398.11	Professional	TC	$151.36	$213.80	$398.11
Select Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $177.83 / $223.87	Professional		$158.49	$177.83	$223.87
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $151.36 / $199.53	Professional	TC	$131.83	$151.36	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $194.98 / $316.23	Professional		$123.03	$194.98	$316.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.72 / $154.88 / $251.19	Professional	TC	$97.72	$154.88	$251.19