Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $11.75 / $15.49	Facility	26	$9.33	$11.75	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $26.30 / $56.23 / $630.96	Facility	TC	$26.30	$56.23	$630.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.50 / $33.88 / $81.28	Professional		$19.50	$33.88	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.00 / $27.54	Professional	26	$7.08	$10.00	$27.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $22.91 / $46.77	Professional	TC	$16.98	$22.91	$46.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $45.71 / $67.61	Professional		$30.90	$45.71	$67.61
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 TC Low / Median / High Price $20.89 / $32.36 / $48.98	Professional	TC	$20.89	$32.36	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $37.15 / $69.18	Professional		$26.30	$37.15	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $21.38	Professional	26	$8.13	$11.48	$21.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $50.12	Professional	TC	$17.78	$25.70	$50.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $54.95 / $89.13	Professional		$50.12	$54.95	$89.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $14.45 / $28.18	Professional	26	$13.18	$14.45	$28.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $40.74 / $60.26	Professional	TC	$37.15	$40.74	$60.26
Select Health Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $35.48 / $51.29	Professional		$31.62	$35.48	$51.29
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 TC Low / Median / High Price $22.39 / $26.30 / $36.31	Professional	TC	$22.39	$26.30	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $41.69 / $67.61	Professional		$28.84	$41.69	$67.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.59 / $20.89	Professional	26	$9.12	$12.59	$20.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $28.84 / $47.86	Professional	TC	$19.95	$28.84	$47.86