Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $10.96 / $17.78 / $162.18	Facility		$10.96	$17.78	$162.18
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.08 / $7.08 / $7.08	Facility	26	$7.08	$7.08	$7.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.33 / $13.49 / $33.88	Professional		$9.33	$13.49	$33.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.32 / $25.70	Professional	26	$6.03	$8.32	$25.70
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $29.51 / $29.51 / $29.51	Professional	50	$29.51	$29.51	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $2.00 / $3.89 / $7.24	Professional	TC	$2.00	$3.89	$7.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $37.15 / $60.26	Facility		$26.92	$37.15	$60.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.60 / $24.55	Professional		$12.30	$16.60	$24.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $10.96 / $15.49	Professional	26	$8.13	$10.96	$15.49
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $15.85 / $20.89 / $34.67	Professional	50	$15.85	$20.89	$34.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $3.80 / $5.13 / $7.41	Professional	TC	$3.80	$5.13	$7.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $7.59 / $56.23 / $102.33	Facility		$7.59	$56.23	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $15.14 / $30.90	Professional		$10.47	$15.14	$30.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.23 / $20.89	Professional	26	$7.08	$10.23	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.16 / $4.90 / $10.23	Professional	TC	$3.16	$4.90	$10.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $16.98 / $19.95 / $67.61	Professional		$16.98	$19.95	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $12.88 / $53.70	Professional	26	$11.22	$12.88	$53.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $5.89 / $6.92 / $12.59	Professional	TC	$5.89	$6.92	$12.59
Select Health Facility/Professional Professional Modifier Low / Median / High Price $11.22 / $12.02 / $15.85	Professional		$11.22	$12.02	$15.85
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $7.76 / $10.96	Professional	26	$7.59	$7.76	$10.96
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $3.47 / $4.17 / $5.50	Professional	TC	$3.47	$4.17	$5.50
United Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $16.60 / $28.18	Professional		$12.30	$16.60	$28.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $11.22 / $18.20	Professional	26	$8.32	$11.22	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $5.37 / $9.12	Professional	TC	$3.63	$5.37	$9.12