Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.31 / $302.00 / $794.33	Facility		$36.31	$302.00	$794.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.96 / $14.13	Facility	26	$8.51	$10.96	$14.13
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.89 / $120.23 / $389.05	Facility	TC	$20.89	$120.23	$389.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $33.11 / $83.18	Professional		$21.88	$33.11	$83.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $11.22 / $34.67	Professional	26	$7.08	$11.22	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $20.89 / $48.98	Professional	TC	$15.14	$20.89	$48.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $91.20 / $144.54	Facility		$66.07	$91.20	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $38.90 / $57.54	Professional		$28.84	$38.90	$57.54
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $11.22 / $16.22	Professional	26	$8.51	$11.22	$16.22
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $27.54 / $40.74	Professional	TC	$19.50	$27.54	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $208.93 / $426.58	Facility		$38.02	$208.93	$426.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $35.48 / $67.61	Professional		$22.39	$35.48	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.96 / $20.42	Professional	26	$7.59	$10.96	$20.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.44 / $46.77	Professional	TC	$15.14	$23.44	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.71 / $107.15	Professional		$41.69	$45.71	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.18 / $33.11	Professional	26	$12.02	$13.18	$33.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $32.36 / $74.13	Professional	TC	$29.51	$32.36	$74.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $29.51 / $43.65	Professional		$26.92	$29.51	$43.65
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $8.51 / $13.18	Professional	26	$8.13	$8.51	$13.18
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $20.89 / $29.51	Professional	TC	$18.62	$20.89	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $37.15 / $61.66	Professional		$25.70	$37.15	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.48 / $19.05	Professional	26	$8.32	$11.48	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $25.70 / $42.66	Professional	TC	$16.98	$25.70	$42.66