Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.88 / $16.60 / $16.60	Facility	26	$12.88	$16.60	$16.60
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $190.55 / $575.44	Facility	TC	$39.81	$190.55	$575.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $42.66 / $87.10	Professional		$32.36	$42.66	$87.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.00 / $14.13 / $33.88	Professional	26	$10.00	$14.13	$33.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $28.18 / $52.48	Professional	TC	$21.88	$28.18	$52.48
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $58.88 / $87.10	Professional		$39.81	$58.88	$87.10
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $16.98 / $25.12	Professional	26	$12.88	$16.98	$25.12
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $41.69 / $61.66	Professional	TC	$25.12	$41.69	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $48.98 / $89.13	Professional		$35.48	$48.98	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.48 / $16.22 / $30.20	Professional	26	$11.48	$16.22	$30.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.11 / $63.10	Professional	TC	$22.91	$33.11	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $69.18 / $239.88	Professional		$63.10	$69.18	$239.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $17.78 / $19.50	Professional	26	$17.78	$17.78	$19.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.67 / $44.67 / $48.98	Professional	TC	$44.67	$44.67	$48.98
Select Health Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $43.65 / $66.07	Professional		$40.74	$43.65	$66.07
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $12.59 / $12.59 / $19.95	Professional	26	$12.59	$12.59	$19.95
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $31.62 / $45.71	Professional	TC	$28.84	$31.62	$45.71
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $54.95 / $89.13	Professional		$38.02	$54.95	$89.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $13.18 / $17.78 / $29.51	Professional	26	$13.18	$17.78	$29.51
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $60.26	Professional	TC	$25.12	$37.15	$60.26