Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $16.98 / $25.12	Facility	26	$13.18	$16.98	$25.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $43.65 / $114.82	Professional		$19.50	$43.65	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $16.98 / $38.02	Professional	26	$10.96	$16.98	$38.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $31.62 / $69.18	Professional	TC	$22.91	$31.62	$69.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $57.54 / $87.10	Professional		$39.81	$57.54	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $25.12	Professional	26	$12.88	$16.98	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $40.74 / $60.26	Professional	TC	$25.12	$40.74	$60.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $48.98 / $89.13	Professional		$33.88	$48.98	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $16.60 / $30.20	Professional	26	$11.48	$16.60	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $31.62 / $60.26	Professional	TC	$21.88	$31.62	$60.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $194.98	Professional		$54.95	$67.61	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.95 / $66.07	Professional	26	$18.20	$19.95	$66.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $47.86 / $128.82	Professional	TC	$43.65	$47.86	$128.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $43.65 / $64.57	Professional		$40.74	$43.65	$64.57
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.88 / $19.95	Professional	26	$12.59	$12.88	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $30.90 / $44.67	Professional	TC	$28.18	$30.90	$44.67
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $53.70 / $87.10	Professional		$37.15	$53.70	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $17.38 / $28.84	Professional	26	$12.88	$17.38	$28.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $35.48 / $58.88	Professional	TC	$24.55	$35.48	$58.88