Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.30 / $151.44 / $354.24	Facility		$43.30	$151.44	$354.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.23 / $12.56 / $18.36	Facility	26	$9.23	$12.56	$18.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.19 / $35.61 / $130.00	Professional		$29.19	$35.61	$130.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $10.97 / $28.30	Professional	26	$9.23	$10.97	$28.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.76 / $25.63 / $65.23	Professional	TC	$19.76	$25.63	$65.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.56 / $38.61 / $44.13	Professional		$35.56	$38.61	$44.13
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.72 / $11.91 / $13.61	Professional	26	$10.72	$11.91	$13.61
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.65 / $26.70 / $30.52	Professional	TC	$23.65	$26.70	$30.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.76 / $40.76 / $40.76	Facility		$40.76	$40.76	$40.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.90 / $40.36 / $74.00	Professional		$28.90	$40.36	$74.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.34 / $12.39 / $24.24	Professional	26	$8.34	$12.39	$24.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.16 / $28.64 / $58.86	Professional	TC	$20.16	$28.64	$58.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.22 / $44.76 / $64.05	Professional		$35.22	$44.76	$64.05
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $12.45 / $18.80	Professional	26	$10.80	$12.45	$18.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.56 / $32.47 / $46.29	Professional	TC	$25.56	$32.47	$46.29
United Facility/Professional Professional Modifier Low / Median / High Price $25.83 / $35.58 / $63.44	Professional		$25.83	$35.58	$63.44
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $12.17 / $23.96	Professional	26	$8.38	$12.17	$23.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.96 / $24.77 / $45.97	Professional	TC	$17.96	$24.77	$45.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.17 / $41.44 / $54.14	Professional		$26.17	$41.44	$54.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $11.52 / $15.71	Professional	26	$7.43	$11.52	$15.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.73 / $30.07 / $38.43	Professional	TC	$18.73	$30.07	$38.43