Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.45 / $28.84	Facility	26	$14.13	$14.45	$28.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.70 / $112.20	Professional		$40.74	$53.70	$112.20
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $14.13 / $30.90	Professional	26	$10.96	$14.13	$30.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $38.02 / $70.79	Professional	TC	$28.84	$38.02	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $72.44 / $107.15	Professional		$52.48	$72.44	$107.15
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $19.50 / $28.84	Professional	26	$14.79	$19.50	$28.84
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $38.90 / $52.48 / $75.86	Professional	TC	$38.90	$52.48	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $67.61 / $120.23	Professional		$45.71	$67.61	$120.23
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.88 / $18.20 / $33.88	Professional	26	$12.88	$18.20	$33.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $50.12 / $89.13	Professional	TC	$34.67	$50.12	$89.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $89.13 / $177.83	Professional		$81.28	$89.13	$177.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $22.91 / $47.86	Professional	26	$20.89	$22.91	$47.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $66.07 / $128.82	Professional	TC	$60.26	$66.07	$128.82
Select Health Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $57.54 / $83.18	Professional		$50.12	$57.54	$83.18
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $14.45 / $22.39	Professional	26	$13.80	$14.45	$22.39
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $36.31 / $42.66 / $60.26	Professional	TC	$36.31	$42.66	$60.26
United Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $123.03	Professional		$41.69	$72.44	$123.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $19.95 / $33.88	Professional	26	$11.22	$19.95	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $51.29 / $87.10	Professional	TC	$30.20	$51.29	$87.10