Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $97.72 / $199.53	Facility		$64.57	$97.72	$199.53
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.59 / $10.00 / $85.11	Facility	26	$7.59	$10.00	$85.11
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $20.42 / $93.33 / $302.00	Facility	TC	$20.42	$93.33	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $33.88 / $109.65	Professional		$19.05	$33.88	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $9.55 / $37.15	Professional	26	$7.94	$9.55	$37.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $18.62 / $45.71	Professional	TC	$10.96	$18.62	$45.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $26.30 / $30.20	Professional		$8.32	$26.30	$30.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $9.33 / $11.75	Professional	26	$7.76	$9.33	$11.75
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $19.95 / $22.39	Professional	TC	$17.78	$19.95	$22.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $17.38 / $17.38 / $40.74	Facility		$17.38	$17.38	$40.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.13 / $14.13 / $14.13	Facility	26	$14.13	$14.13	$14.13
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $26.92 / $26.92 / $26.92	Facility	TC	$26.92	$26.92	$26.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $25.70 / $51.29	Professional		$17.78	$25.70	$51.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $10.23 / $19.50	Professional	26	$6.61	$10.23	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $15.49 / $34.67	Professional	TC	$9.77	$15.49	$34.67
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $29.51 / $40.74	Professional		$26.92	$29.51	$40.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $12.88	Professional	26	$8.51	$9.55	$12.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $19.95 / $27.54	Professional	TC	$18.20	$19.95	$27.54
United Facility/Professional Facility Modifier Low / Median / High Price $6.76 / $10.72 / $19.95	Facility		$6.76	$10.72	$19.95
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $24.55 / $45.71	Professional		$16.22	$24.55	$45.71
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $9.33 / $16.22	Professional	26	$7.08	$9.33	$16.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.12 / $15.85 / $28.18	Professional	TC	$9.12	$15.85	$28.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $30.90 / $42.66	Professional		$17.38	$30.90	$42.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $10.00 / $13.18	Professional	26	$5.62	$10.00	$13.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $20.89 / $28.84	Professional	TC	$11.75	$20.89	$28.84