Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $11.75 / $16.98	Facility	26	$9.33	$11.75	$16.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $61.66 / $158.49	Professional		$50.12	$61.66	$158.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.55 / $28.18	Professional	26	$7.94	$9.55	$28.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $8.13 / $8.32 / $39.81	Professional	52	$8.13	$8.32	$39.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.69 / $50.12 / $87.10	Professional	TC	$41.69	$50.12	$87.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $74.13 / $112.20	Professional		$56.23	$74.13	$112.20
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $8.13 / $11.48 / $16.60	Professional	26	$8.13	$11.48	$16.60
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $63.10 / $95.50	Professional	TC	$47.86	$63.10	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $112.20	Professional		$58.88	$75.86	$112.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $11.75 / $18.20	Professional	26	$9.12	$11.75	$18.20
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $64.57 / $95.50	Professional	TC	$48.98	$64.57	$95.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $95.50 / $125.89	Professional		$61.66	$95.50	$125.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $13.49 / $18.62	Professional	26	$8.71	$13.49	$18.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $81.28 / $107.15	Professional	TC	$52.48	$81.28	$107.15
Select Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $67.61 / $67.61	Professional		$56.23	$67.61	$67.61
Select Health Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $13.49	Professional	26	$8.51	$9.55	$13.49
Select Health Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $57.54 / $57.54	Professional	TC	$46.77	$57.54	$57.54
United Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $77.62 / $112.20	Professional		$54.95	$77.62	$112.20
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $12.30 / $18.20	Professional	26	$8.91	$12.30	$18.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $64.57 / $95.50	Professional	TC	$46.77	$64.57	$95.50