Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $15.49 / $15.49 / $22.91	Facility		$15.49	$15.49	$22.91
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.91 / $8.91 / $13.49	Facility	26	$8.91	$8.91	$13.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $6.46 / $9.55 / $128.82	Facility	TC	$6.46	$9.55	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.88 / $17.78 / $70.79	Professional		$12.88	$17.78	$70.79
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $23.44 / $91.20	Professional	26	$8.71	$23.44	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $5.01 / $6.03 / $12.88	Professional	TC	$5.01	$6.03	$12.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $20.89 / $36.31	Professional		$20.89	$20.89	$36.31
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $12.30 / $12.30 / $20.89	Professional	26	$12.30	$12.30	$20.89
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $8.71 / $8.71 / $15.14	Professional	TC	$8.71	$8.71	$15.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $16.60 / $35.48	Professional		$7.94	$16.60	$35.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.25 / $10.47 / $25.70	Professional	26	$5.25	$10.47	$25.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $2.69 / $5.62 / $13.80	Professional	TC	$2.69	$5.62	$13.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $28.84 / $28.84	Professional		$28.84	$28.84	$28.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $16.22 / $16.22	Professional	26	$16.22	$16.22	$16.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $12.30 / $12.30 / $12.30	Professional	TC	$12.30	$12.30	$12.30
Select Health Facility/Professional Professional Modifier Low / Median / High Price $18.62 / $20.42 / $33.88	Professional		$18.62	$20.42	$33.88
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $11.48 / $20.42	Professional	26	$11.22	$11.48	$20.42
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $7.59 / $8.71 / $13.18	Professional	TC	$7.59	$8.71	$13.18
United Facility/Professional Professional Modifier Low / Median / High Price $10.47 / $13.18 / $42.66	Professional		$10.47	$13.18	$42.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $7.76 / $25.70	Professional	26	$6.76	$7.76	$25.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $3.63 / $5.37 / $16.98	Professional	TC	$3.63	$5.37	$16.98