Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $257.04 / $870.96	Facility		$61.66	$257.04	$870.96
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $10.96 / $14.13 / $20.89	Facility	26	$10.96	$14.13	$20.89
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $218.78 / $436.52	Facility	TC	$48.98	$218.78	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.72 / $44.67 / $128.82	Professional		$10.72	$44.67	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $14.13 / $45.71	Professional	26	$8.91	$14.13	$45.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.30 / $120.23 / $186.21	Professional	50	$26.30	$120.23	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $40.74 / $89.13	Professional	TC	$28.18	$40.74	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $158.49 / $257.04	Facility		$114.82	$158.49	$257.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $64.57 / $95.50	Professional		$42.66	$64.57	$95.50
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $14.13 / $20.89	Professional	26	$10.72	$14.13	$20.89
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $50.12 / $63.10 / $85.11	Professional	50	$50.12	$63.10	$85.11
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $48.98 / $74.13	Professional	TC	$30.20	$48.98	$74.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.07 / $181.97 / $354.81	Facility		$66.07	$181.97	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $53.70 / $97.72	Professional		$37.15	$53.70	$97.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.77 / $13.80 / $25.12	Professional	26	$9.77	$13.80	$25.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $38.90 / $75.86	Professional	TC	$26.92	$38.90	$75.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $79.43 / $194.98	Professional		$72.44	$79.43	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $16.98 / $54.95	Professional	26	$15.49	$16.98	$54.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $63.10 / $141.25	Professional	TC	$57.54	$63.10	$141.25
Select Health Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $51.29 / $72.44	Professional		$44.67	$51.29	$72.44
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $10.96 / $16.98	Professional	26	$10.47	$10.96	$16.98
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $33.88 / $40.74 / $56.23	Professional	TC	$33.88	$40.74	$56.23
United Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $60.26 / $95.50	Professional		$40.74	$60.26	$95.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $15.14 / $24.55	Professional	26	$10.96	$15.14	$24.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $44.67 / $72.44	Professional	TC	$30.20	$44.67	$72.44