Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $309.03 / $831.76	Facility		$54.95	$309.03	$831.76
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $12.02 / $17.38	Facility	26	$9.33	$12.02	$17.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $41.69 / $257.04 / $616.60	Facility	TC	$41.69	$257.04	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $42.66 / $128.82	Professional		$9.33	$42.66	$128.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $16.98 / $50.12	Professional	26	$8.32	$16.98	$50.12
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $25.70 / $89.13 / $223.87	Professional	50	$25.70	$89.13	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $89.13	Professional	TC	$25.12	$41.69	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $138.04 / $223.87	Facility		$100.00	$138.04	$223.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $56.23 / $83.18	Professional		$36.31	$56.23	$83.18
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $12.30 / $17.78	Professional	26	$9.12	$12.30	$17.78
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $44.67 / $54.95 / $79.43	Professional	50	$44.67	$54.95	$79.43
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $42.66 / $64.57	Professional	TC	$26.30	$42.66	$64.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $125.89 / $354.81	Facility		$57.54	$125.89	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $85.11	Professional		$29.51	$45.71	$85.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $12.02 / $21.88	Professional	26	$8.13	$12.02	$21.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $33.88 / $63.10	Professional	TC	$21.38	$33.88	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $69.18 / $169.82	Professional		$52.48	$69.18	$169.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.49 / $14.79 / $50.12	Professional	26	$13.49	$14.79	$50.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.12 / $54.95 / $120.23	Professional	TC	$50.12	$54.95	$120.23
Select Health Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $44.67 / $61.66	Professional		$38.90	$44.67	$61.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $9.55 / $14.13	Professional	26	$8.91	$9.55	$14.13
Select Health Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $181.97 / $181.97	Professional	50	$181.97	$181.97	$181.97
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $35.48 / $47.86	Professional	TC	$29.51	$35.48	$47.86
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $50.12 / $83.18	Professional		$33.88	$50.12	$83.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.30 / $20.42	Professional	26	$8.71	$12.30	$20.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.02 / $63.10	Professional	TC	$23.99	$38.02	$63.10