Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $31.62 / $40.74	Facility	26	$23.99	$31.62	$40.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $53.70 / $107.15	Professional		$36.31	$53.70	$107.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $33.88 / $81.28	Professional	26	$22.91	$33.88	$81.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $12.88 / $22.91 / $70.79	Professional	TC	$12.88	$22.91	$70.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $56.23 / $91.20	Professional		$42.66	$56.23	$91.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $33.88 / $46.77	Professional	26	$24.55	$33.88	$46.77
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $16.60 / $22.39 / $47.86	Professional	TC	$16.60	$22.39	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $77.62 / $134.90	Professional		$44.67	$77.62	$134.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $63.10	Professional	26	$22.91	$36.31	$63.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $41.69 / $83.18	Professional	TC	$21.88	$41.69	$83.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $66.07 / $331.13	Professional		$60.26	$66.07	$331.13
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $38.02 / $117.49	Professional	26	$34.67	$38.02	$117.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $28.18 / $208.93	Professional	TC	$25.70	$28.18	$208.93
Select Health Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $42.66 / $42.66	Professional		$37.15	$42.66	$42.66
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $24.55 / $24.55	Professional	26	$23.44	$24.55	$24.55
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $13.49 / $18.20 / $18.20	Professional	TC	$13.49	$18.20	$18.20
United Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.72 / $144.54	Professional		$63.10	$97.72	$144.54
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $35.48 / $57.54	Professional	26	$30.90	$35.48	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $56.23 / $87.10	Professional	TC	$30.20	$56.23	$87.10