Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.12 / $288.40 / $660.69	Facility		$50.12	$288.40	$660.69
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.94 / $10.00 / $13.18	Facility	26	$7.94	$10.00	$13.18
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $186.21 / $436.52	Facility	TC	$25.70	$186.21	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $33.11 / $95.50	Professional		$10.47	$33.11	$95.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $14.13 / $42.66	Professional	26	$7.08	$14.13	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $42.66 / $120.23 / $257.04	Professional	50	$42.66	$120.23	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $27.54 / $60.26	Professional	TC	$18.20	$27.54	$60.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $102.33 / $162.18	Facility		$74.13	$102.33	$162.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $43.65 / $64.57	Professional		$29.51	$43.65	$64.57
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 $38.90 / $44.67 / $64.57	Professional	50	$38.90	$44.67	$64.57
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 Facility Modifier Low / Median / High Price $43.65 / $125.89 / $354.81	Facility		$43.65	$125.89	$354.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $36.31 / $66.07	Professional		$23.44	$36.31	$66.07
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 $16.60 / $25.70 / $47.86	Professional	TC	$16.60	$25.70	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $51.29 / $134.90	Professional		$40.74	$51.29	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $41.69	Professional	26	$10.96	$12.30	$41.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.90 / $93.33	Professional	TC	$35.48	$38.90	$93.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.11 / $48.98	Professional		$30.20	$33.11	$48.98
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 $102.33 / $102.33 / $102.33	Professional	50	$102.33	$102.33	$102.33
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $25.12 / $36.31	Professional	TC	$22.39	$25.12	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $39.81 / $64.57	Professional		$26.92	$39.81	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.96 / $17.78	Professional	26	$8.13	$10.96	$17.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $28.84 / $47.86	Professional	TC	$18.20	$28.84	$47.86