Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $288.40 / $691.83	Facility		$53.70	$288.40	$691.83
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.51 / $10.96 / $16.22	Facility	26	$8.51	$10.96	$16.22
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.62 / $275.42 / $660.69	Facility	TC	$31.62	$275.42	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $35.48 / $102.33	Professional		$11.22	$35.48	$102.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $13.18 / $40.74	Professional	26	$7.24	$13.18	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $30.20 / $128.82 / $295.12	Professional	50	$30.20	$128.82	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $33.11 / $63.10	Professional	TC	$19.05	$33.11	$63.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $107.15 / $173.78	Facility		$77.62	$107.15	$173.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $45.71 / $66.07	Professional		$31.62	$45.71	$66.07
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 50 Low / Median / High Price $42.66 / $48.98 / $69.18	Professional	50	$42.66	$48.98	$69.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.88 / $50.12	Professional	TC	$22.91	$33.88	$50.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $125.89 / $354.81	Facility		$42.66	$125.89	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $40.74 / $70.79	Professional		$28.18	$40.74	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.96 / $19.95	Professional	26	$7.59	$10.96	$19.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $28.18 / $51.29	Professional	TC	$20.42	$28.18	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $53.70 / $134.90	Professional		$47.86	$53.70	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $13.18 / $38.02	Professional	26	$12.02	$13.18	$38.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $40.74 / $97.72	Professional	TC	$37.15	$40.74	$97.72
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $34.67 / $50.12	Professional		$30.90	$34.67	$50.12
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 50 Low / Median / High Price $154.88 / $154.88 / $154.88	Professional	50	$154.88	$154.88	$154.88
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $26.30 / $37.15	Professional	TC	$22.91	$26.30	$37.15
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $41.69 / $67.61	Professional		$30.90	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $19.05	Professional	26	$8.32	$11.22	$19.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $30.20 / $48.98	Professional	TC	$21.88	$30.20	$48.98