Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $43.65 / $53.70 / $69.18	Facility	26	$43.65	$53.70	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $89.13 / $194.98	Professional		$66.07	$89.13	$194.98
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $47.86 / $138.04	Professional	26	$38.02	$47.86	$138.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.90 / $67.61	Professional	TC	$21.88	$38.90	$67.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $114.82 / $165.96	Professional		$70.79	$114.82	$165.96
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 $28.18 / $56.23 / $83.18	Professional	TC	$28.18	$56.23	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $102.33 / $158.49	Professional		$75.86	$102.33	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $58.88 / $100.00	Professional	26	$45.71	$58.88	$100.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $43.65 / $74.13	Professional	TC	$25.12	$43.65	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $125.89 / $257.04	Professional		$75.86	$125.89	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $63.10 / $169.82	Professional	26	$38.02	$63.10	$169.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $61.66 / $89.13	Professional	TC	$37.15	$61.66	$89.13
Select Health Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $81.28 / $85.11	Professional		$77.62	$81.28	$85.11
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $41.69 / $44.67	Professional	26	$39.81	$41.69	$44.67
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $40.74 / $42.66	Professional	TC	$37.15	$40.74	$42.66
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $100.00 / $151.36	Professional		$70.79	$100.00	$151.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $61.66 / $93.33	Professional	26	$44.67	$61.66	$93.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $39.81 / $67.61	Professional	TC	$23.99	$39.81	$67.61