Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $56.23 / $77.62	Professional		$44.67	$56.23	$77.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $20.89 / $28.84	Professional	26	$15.85	$20.89	$28.84
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $36.31 / $51.29	Professional	TC	$26.92	$36.31	$51.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $79.43 / $134.90	Professional		$79.43	$79.43	$134.90
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $44.67	Professional	26	$25.70	$25.70	$44.67
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $52.48 / $91.20	Professional	TC	$52.48	$52.48	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $50.12 / $125.89	Professional		$22.39	$50.12	$125.89
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $20.89 / $50.12	Professional	26	$10.72	$20.89	$50.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $29.51 / $87.10	Professional	TC	$11.75	$29.51	$87.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $120.23	Professional		$120.23	$120.23	$120.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.67 / $34.67 / $34.67	Professional	26	$34.67	$34.67	$34.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $85.11 / $85.11	Professional	TC	$85.11	$85.11	$85.11
Select Health Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $85.11 / $134.90	Professional		$75.86	$85.11	$134.90
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $24.55 / $42.66	Professional	26	$23.44	$24.55	$42.66
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $60.26 / $93.33	Professional	TC	$52.48	$60.26	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $47.86 / $141.25	Professional		$30.90	$47.86	$141.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $16.22 / $53.70	Professional	26	$14.45	$16.22	$53.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $33.11 / $89.13	Professional	TC	$16.22	$33.11	$89.13