Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $346.74 / $831.76	Facility		$53.70	$346.74	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $12.02 / $18.62	Facility	26	$9.33	$12.02	$18.62
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.18 / $194.98 / $512.86	Facility	TC	$28.18	$194.98	$512.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $38.02 / $107.15	Professional		$9.12	$38.02	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $13.80 / $47.86	Professional	26	$7.94	$13.80	$47.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $33.88 / $74.13 / $199.53	Professional	50	$33.88	$74.13	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $36.31 / $77.62	Professional	TC	$19.95	$36.31	$77.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $117.49 / $186.21	Facility		$85.11	$117.49	$186.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $47.86 / $70.79	Professional		$30.20	$47.86	$70.79
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.02 / $17.78	Professional	26	$9.12	$12.02	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $46.77 / $70.79	Professional	50	$42.66	$46.77	$70.79
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $34.67 / $52.48	Professional	TC	$19.95	$34.67	$52.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.71 / $173.78 / $354.81	Facility		$45.71	$173.78	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $38.90 / $72.44	Professional		$25.70	$38.90	$72.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.02 / $21.88	Professional	26	$8.13	$12.02	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $51.29	Professional	TC	$17.78	$25.70	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $58.88 / $141.25	Professional		$44.67	$58.88	$141.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.45 / $40.74	Professional	26	$13.18	$14.45	$40.74
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $44.67 / $100.00	Professional	TC	$39.81	$44.67	$100.00
Select Health Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $37.15 / $53.70	Professional		$33.11	$37.15	$53.70
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.12 / $14.13	Professional	26	$8.91	$9.12	$14.13
Select Health Facility/Professional Professional Modifier 50 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	50	$144.54	$144.54	$144.54
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $28.18 / $38.90	Professional	TC	$24.55	$28.18	$38.90
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $42.66 / $70.79	Professional		$29.51	$42.66	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $20.42	Professional	26	$8.71	$12.30	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $29.51 / $50.12	Professional	TC	$20.42	$29.51	$50.12