Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.75 / $263.33 / $310.61	Facility		$63.75	$263.33	$310.61
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.51 / $10.67 / $14.94	Facility	26	$7.51	$10.67	$14.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.53 / $136.63 / $390.72	Facility	TC	$24.53	$136.63	$390.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.04 / $38.46 / $176.47	Professional		$32.04	$38.46	$176.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $11.28 / $31.38	Professional	26	$7.51	$11.28	$31.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.79 / $26.99 / $71.77	Professional	TC	$22.79	$26.99	$71.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.49 / $39.82 / $45.43	Professional		$37.49	$39.82	$45.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.40 / $12.01 / $13.73	Professional	26	$11.40	$12.01	$13.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.04 / $27.74 / $31.70	Professional	TC	$27.04	$27.74	$31.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.28 / $44.28 / $44.28	Facility		$44.28	$44.28	$44.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.92 / $44.35 / $84.02	Professional		$28.92	$44.35	$84.02
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $12.86 / $23.17	Professional	26	$6.81	$12.86	$23.17
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.93 / $31.00 / $61.09	Professional	TC	$21.93	$31.00	$61.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $37.47 / $44.11 / $62.56	Professional		$37.47	$44.11	$62.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.77 / $11.35 / $18.46	Professional	26	$8.77	$11.35	$18.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.28 / $34.14 / $48.13	Professional	TC	$27.28	$34.14	$48.13
United Facility/Professional Professional Modifier Low / Median / High Price $28.89 / $39.70 / $66.05	Professional		$28.89	$39.70	$66.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.42 / $10.47 / $18.86	Professional	26	$8.42	$10.47	$18.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.10 / $26.08 / $45.62	Professional	TC	$20.10	$26.08	$45.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $40.84 / $53.16	Professional		$28.69	$40.84	$53.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.74 / $9.36 / $12.77	Professional	26	$6.74	$9.36	$12.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $31.61 / $40.39	Professional	TC	$21.95	$31.61	$40.39