Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.00 / $13.49 / $17.78	Facility	26	$10.00	$13.49	$17.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $41.69 / $102.33	Professional		$31.62	$41.69	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $10.00 / $23.99	Professional	26	$7.94	$10.00	$23.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $30.90 / $57.54	Professional	TC	$22.91	$30.90	$57.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $56.23 / $85.11	Professional		$37.15	$56.23	$85.11
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $14.13 / $20.42	Professional	26	$10.47	$14.13	$20.42
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $63.10	Professional	TC	$25.12	$41.69	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $46.77 / $85.11	Professional		$32.36	$46.77	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $13.80 / $24.55	Professional	26	$9.33	$13.80	$24.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $33.11 / $63.10	Professional	TC	$21.88	$33.11	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $67.61 / $181.97	Professional		$54.95	$67.61	$181.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $16.60 / $52.48	Professional	26	$15.14	$16.60	$52.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $51.29 / $128.82	Professional	TC	$46.77	$51.29	$128.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $43.65 / $63.10	Professional		$39.81	$43.65	$63.10
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $10.47 / $16.60	Professional	26	$10.23	$10.47	$16.60
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.11 / $46.77	Professional	TC	$28.84	$33.11	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $52.48 / $85.11	Professional		$36.31	$52.48	$85.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.45 / $24.55	Professional	26	$10.23	$14.45	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $37.15 / $61.66	Professional	TC	$25.70	$37.15	$61.66