Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $14.45 / $20.89	Facility	26	$10.96	$14.45	$20.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $46.77 / $112.20	Professional		$33.11	$46.77	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $33.11	Professional	26	$8.91	$14.13	$33.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $32.36 / $63.10	Professional	TC	$22.91	$32.36	$63.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $83.18	Professional		$41.69	$57.54	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.45 / $20.89	Professional	26	$10.96	$14.45	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $42.66 / $61.66	Professional	TC	$29.51	$42.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $53.70 / $95.50	Professional		$37.15	$53.70	$95.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $14.13 / $26.30	Professional	26	$9.77	$14.13	$26.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $38.90 / $69.18	Professional	TC	$26.30	$38.90	$69.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $69.18 / $114.82	Professional		$61.66	$69.18	$114.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $16.98 / $27.54	Professional	26	$15.49	$16.98	$27.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $52.48 / $87.10	Professional	TC	$46.77	$52.48	$87.10
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $61.66	Professional		$38.90	$44.67	$61.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.96 / $16.98	Professional	26	$10.47	$10.96	$16.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.11 / $45.71	Professional	TC	$28.84	$33.11	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.70 / $87.10	Professional		$39.81	$53.70	$87.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $14.79 / $24.55	Professional	26	$10.23	$14.79	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $61.66	Professional	TC	$28.18	$40.74	$61.66