Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $29.51 / $37.15 / $75.86	Facility	26	$29.51	$37.15	$75.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $147.91	Professional		$43.65	$58.88	$147.91
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $43.65 / $95.50	Professional	26	$25.70	$43.65	$95.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $23.99 / $43.65 / $134.90	Professional	52	$23.99	$43.65	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $25.70 / $58.88	Professional	TC	$19.95	$25.70	$58.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $107.15	Professional		$54.95	$70.79	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $38.90 / $57.54	Professional	26	$29.51	$38.90	$57.54
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $50.12	Professional	TC	$25.12	$33.88	$50.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $66.07 / $123.03	Professional		$46.77	$66.07	$123.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $36.31 / $67.61	Professional	26	$25.70	$36.31	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $30.20 / $56.23	Professional	TC	$20.89	$30.20	$56.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $87.10 / $302.00	Professional		$75.86	$87.10	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $43.65 / $162.18	Professional	26	$39.81	$43.65	$162.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $38.90 / $138.04	Professional	TC	$35.48	$38.90	$138.04
Select Health Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $52.48 / $81.28	Professional		$51.29	$52.48	$81.28
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $28.18 / $44.67	Professional	26	$27.54	$28.18	$44.67
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 $56.23 / $74.13 / $120.23	Professional		$56.23	$74.13	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $39.81 / $66.07	Professional	26	$30.90	$39.81	$66.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $54.95	Professional	TC	$25.12	$33.88	$54.95