Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $43.65 / $69.18	Facility	26	$43.65	$43.65	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $91.20 / $194.98	Professional		$69.18	$91.20	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $131.83	Professional	26	$38.02	$47.86	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.55 / $42.66 / $74.13	Professional	TC	$24.55	$42.66	$74.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $120.23 / $173.78	Professional		$77.62	$120.23	$173.78
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $56.23 / $83.18	Professional	26	$42.66	$56.23	$83.18
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $61.66 / $91.20	Professional	TC	$25.70	$61.66	$91.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $107.15 / $165.96	Professional		$83.18	$107.15	$165.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $61.66 / $107.15	Professional	26	$47.86	$61.66	$107.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $48.98 / $81.28	Professional	TC	$28.18	$48.98	$81.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $131.83 / $269.15	Professional		$79.43	$131.83	$269.15
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $64.57 / $173.78	Professional	26	$38.02	$64.57	$173.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $69.18 / $93.33	Professional	TC	$40.74	$69.18	$93.33
Select Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $87.10 / $89.13	Professional		$81.28	$87.10	$89.13
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $46.77	Professional	26	$39.81	$41.69	$46.77
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $44.67 / $46.77	Professional	TC	$40.74	$44.67	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $158.49	Professional		$75.86	$104.71	$158.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $61.66 / $93.33	Professional	26	$46.77	$61.66	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $43.65 / $72.44	Professional	TC	$26.92	$43.65	$72.44