Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.14 / $19.50 / $25.70	Facility	26	$15.14	$19.50	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $64.57 / $181.97	Professional		$48.98	$64.57	$181.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.02 / $18.20 / $47.86	Professional	26	$12.02	$18.20	$47.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $45.71 / $100.00	Professional	TC	$34.67	$45.71	$100.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $125.89	Professional		$57.54	$85.11	$125.89
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $15.14 / $19.95 / $29.51	Professional	26	$15.14	$19.95	$29.51
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $64.57 / $97.72	Professional	TC	$40.74	$64.57	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $70.79 / $128.82	Professional		$51.29	$70.79	$128.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $19.05 / $35.48	Professional	26	$13.49	$19.05	$35.48
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $52.48 / $97.72	Professional	TC	$36.31	$52.48	$97.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $100.00 / $302.00	Professional		$91.20	$100.00	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $23.44 / $89.13	Professional	26	$21.38	$23.44	$89.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $213.80	Professional	TC	$70.79	$77.62	$213.80
Select Health Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $64.57 / $95.50	Professional		$58.88	$64.57	$95.50
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $14.79 / $23.99	Professional	26	$14.79	$14.79	$23.99
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $50.12 / $70.79	Professional	TC	$44.67	$50.12	$70.79
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $77.62 / $125.89	Professional		$53.70	$77.62	$125.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $21.38 / $34.67	Professional	26	$15.49	$21.38	$34.67
United Facility/Professional Professional Modifier TC Low / Median / High Price $39.81 / $57.54 / $93.33	Professional	TC	$39.81	$57.54	$93.33