Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.06 / $96.82 / $192.46	Facility		$62.06	$96.82	$192.46
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $10.21 / $14.94	Facility	26	$7.50	$10.21	$14.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.34 / $98.40 / $257.76	Facility	TC	$21.34	$98.40	$257.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.48 / $24.91 / $109.00	Professional		$18.48	$24.91	$109.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.43 / $34.00	Professional	26	$7.79	$9.43	$34.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $9.74 / $15.58 / $41.43	Professional	TC	$9.74	$15.58	$41.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $27.72 / $31.69	Professional		$24.95	$27.72	$31.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $10.26 / $11.68	Professional	26	$9.23	$10.26	$11.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $15.72 / $17.46 / $19.96	Professional	TC	$15.72	$17.46	$19.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.39 / $17.39 / $17.39	Facility		$17.39	$17.39	$17.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $26.59 / $56.81	Professional		$18.60	$26.59	$56.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $10.28 / $19.55	Professional	26	$6.80	$10.28	$19.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $10.40 / $16.51 / $38.79	Professional	TC	$10.40	$16.51	$38.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $32.20 / $44.67	Professional		$26.86	$32.20	$44.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $10.15 / $14.43	Professional	26	$8.68	$10.15	$14.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.04 / $21.85 / $30.24	Professional	TC	$18.04	$21.85	$30.24
United Facility/Professional Professional Modifier Low / Median / High Price $16.35 / $25.06 / $47.00	Professional		$16.35	$25.06	$47.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.17 / $9.90 / $16.05	Professional	26	$7.17	$9.90	$16.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.18 / $16.23 / $31.11	Professional	TC	$9.18	$16.23	$31.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.29 / $29.27 / $38.36	Professional		$17.29	$29.27	$38.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.63 / $9.36 / $12.77	Professional	26	$5.63	$9.36	$12.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.66 / $20.04 / $25.62	Professional	TC	$11.66	$20.04	$25.62