Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $229.09 / $676.08	Facility		$39.81	$229.09	$676.08
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $15.49	Facility	26	$7.94	$10.00	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $151.36 / $426.58	Facility	TC	$23.44	$151.36	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $30.90 / $81.28	Professional		$10.47	$30.90	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $13.18 / $42.66	Professional	26	$7.08	$13.18	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $79.43 / $281.84	Professional	50	$15.49	$79.43	$281.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $23.99 / $48.98	Professional	TC	$16.98	$23.99	$48.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $93.33 / $151.36	Facility		$69.18	$93.33	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $58.88	Professional		$26.92	$40.74	$58.88
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $10.47 / $15.14	Professional	26	$7.76	$10.47	$15.14
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $38.02 / $41.69 / $63.10	Professional	50	$38.02	$41.69	$63.10
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $44.67	Professional	TC	$19.05	$30.20	$44.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $173.78 / $354.81	Facility		$39.81	$173.78	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $34.67 / $63.10	Professional		$23.44	$34.67	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $10.23 / $18.62	Professional	26	$6.92	$10.23	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $23.44 / $44.67	Professional	TC	$16.22	$23.44	$44.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $47.86 / $123.03	Professional		$39.81	$47.86	$123.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $35.48	Professional	26	$10.96	$12.30	$35.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $35.48 / $87.10	Professional	TC	$32.36	$35.48	$87.10
Select Health Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $30.20 / $44.67	Professional		$28.18	$30.20	$44.67
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.76 / $12.59	Professional	26	$7.59	$7.76	$12.59
Select Health Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	50	$128.82	$128.82	$128.82
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $22.91 / $33.11	Professional	TC	$20.42	$22.91	$33.11
United Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $61.66	Professional		$26.30	$37.15	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $10.72 / $18.20	Professional	26	$7.59	$10.72	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.30 / $43.65	Professional	TC	$18.20	$26.30	$43.65