Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $25.70 / $38.02	Facility		$25.70	$25.70	$38.02
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $5.01 / $5.01 / $7.41	Facility	26	$5.01	$5.01	$7.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $45.71 / $120.23	Professional		$20.89	$45.71	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $20.89 / $50.12	Professional	26	$5.01	$20.89	$50.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $22.39 / $48.98	Professional	TC	$14.13	$22.39	$48.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $64.57	Professional		$34.67	$34.67	$64.57
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $6.76 / $11.75	Professional	26	$6.76	$6.76	$11.75
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $27.54 / $53.70	Professional	TC	$27.54	$27.54	$53.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.79 / $23.99 / $69.18	Professional		$14.79	$23.99	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.88 / $5.75 / $16.60	Professional	26	$2.88	$5.75	$16.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.48 / $18.62 / $53.70	Professional	TC	$11.48	$18.62	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Professional		$47.86	$47.86	$47.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $9.55 / $9.55	Professional	26	$9.55	$9.55	$9.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.02 / $38.02 / $38.02	Professional	TC	$38.02	$38.02	$38.02
Select Health Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.88 / $53.70	Professional		$30.20	$33.88	$53.70
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $6.76 / $11.22	Professional	26	$6.31	$6.76	$11.22
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $27.54 / $42.66	Professional	TC	$23.44	$27.54	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $29.51 / $64.57	Professional		$19.05	$29.51	$64.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.89 / $4.37 / $14.45	Professional	26	$3.89	$4.37	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $25.12 / $50.12	Professional	TC	$14.45	$25.12	$50.12