Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $11.75 / $14.45	Facility	26	$8.91	$11.75	$14.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $34.67 / $85.11	Professional		$22.91	$34.67	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $28.84	Professional	26	$7.08	$10.00	$28.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $30.20 / $38.90 / $54.95	Professional	52	$30.20	$38.90	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $47.86	Professional	TC	$15.14	$21.88	$47.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $39.81 / $58.88	Professional		$30.20	$39.81	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $17.78	Professional	26	$9.12	$12.30	$17.78
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $28.18 / $40.74	Professional	TC	$20.89	$28.18	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $41.69 / $77.62	Professional		$26.92	$41.69	$77.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.59 / $22.91	Professional	26	$8.13	$12.59	$22.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $28.18 / $54.95	Professional	TC	$18.62	$28.18	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $54.95 / $107.15	Professional		$45.71	$54.95	$107.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.79 / $30.20	Professional	26	$13.49	$14.79	$30.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $34.67 / $77.62	Professional	TC	$31.62	$34.67	$77.62
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $31.62 / $44.67	Professional		$28.18	$31.62	$44.67
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.55 / $14.13	Professional	26	$8.91	$9.55	$14.13
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.39 / $30.20	Professional	TC	$19.05	$22.39	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $43.65 / $74.13	Professional		$31.62	$43.65	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $12.88 / $21.38	Professional	26	$9.77	$12.88	$21.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $50.12	Professional	TC	$21.88	$30.20	$50.12