Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.12 / $30.20 / $40.74	Facility		$25.12	$30.20	$40.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $3.02 / $3.89 / $5.01	Facility	26	$3.02	$3.89	$5.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $28.84 / $81.28	Professional		$18.20	$28.84	$81.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.00 / $3.02 / $10.72	Professional	26	$2.00	$3.02	$10.72
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.60 / $21.88 / $36.31	Professional	52	$16.60	$21.88	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $41.69	Professional	TC	$15.14	$21.88	$41.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $53.70	Professional		$22.39	$33.88	$53.70
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $4.27 / $10.72	Professional	26	$3.24	$4.27	$10.72
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $30.90 / $36.31 / $60.26	Professional	50	$30.90	$36.31	$60.26
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $28.18 / $40.74	Professional	TC	$17.78	$28.18	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Facility		$63.10	$63.10	$63.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.89 / $36.31 / $64.57	Professional		$20.89	$36.31	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $5.13 / $14.45	Professional	26	$2.95	$5.13	$14.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $30.90 / $47.86	Professional	TC	$17.78	$30.90	$47.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $38.90 / $125.89	Professional		$35.48	$38.90	$125.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $4.68 / $31.62	Professional	26	$4.27	$4.68	$31.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $33.88 / $95.50	Professional	TC	$30.90	$33.88	$95.50
Select Health Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $25.12 / $34.67	Professional		$21.88	$25.12	$34.67
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $2.95 / $3.02 / $4.68	Professional	26	$2.95	$3.02	$4.68
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $21.88 / $28.84	Professional	TC	$19.05	$21.88	$28.84
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $36.31 / $61.66	Professional		$22.39	$36.31	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $3.24 / $5.50 / $14.45	Professional	26	$3.24	$5.50	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $30.20 / $45.71	Professional	TC	$19.05	$30.20	$45.71