Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $16.60 / $21.88	Facility	26	$13.18	$16.60	$21.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $64.57 / $162.18	Professional		$42.66	$64.57	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $20.42 / $51.29	Professional	26	$10.96	$20.42	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $43.65 / $97.72	Professional	TC	$30.90	$43.65	$97.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $70.79 / $104.71	Professional		$50.12	$70.79	$104.71
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $16.98 / $25.12	Professional	26	$12.59	$16.98	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $53.70 / $81.28	Professional	TC	$33.88	$53.70	$81.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $63.10 / $112.20	Professional		$44.67	$63.10	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $18.20 / $33.88	Professional	26	$11.22	$18.20	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $43.65 / $81.28	Professional	TC	$30.90	$43.65	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $223.87	Professional		$75.86	$87.10	$223.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $19.95 / $67.61	Professional	26	$18.20	$19.95	$67.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $67.61 / $154.88	Professional	TC	$61.66	$67.61	$154.88
Select Health Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $56.23 / $79.43	Professional		$48.98	$56.23	$79.43
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.88 / $19.95	Professional	26	$12.30	$12.88	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $43.65 / $58.88	Professional	TC	$37.15	$43.65	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $107.15	Professional		$48.98	$64.57	$107.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $18.20 / $30.20	Professional	26	$13.49	$18.20	$30.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $47.86 / $77.62	Professional	TC	$33.88	$47.86	$77.62