Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.23 / $184.00 / $296.67	Facility		$91.23	$184.00	$296.67
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 Facility Modifier TC Low / Median / High Price $31.22 / $132.80 / $245.38	Facility	TC	$31.22	$132.80	$245.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $45.12 / $165.00	Professional		$35.10	$45.12	$165.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $13.83 / $36.90	Professional	26	$9.59	$13.83	$36.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $24.80 / $31.24 / $78.95	Professional	TC	$24.80	$31.24	$78.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $44.20 / $50.52	Professional		$35.00	$44.20	$50.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.07 / $12.68 / $14.49	Professional	26	$11.07	$12.68	$14.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.93 / $31.52 / $36.03	Professional	TC	$23.93	$31.52	$36.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $42.11 / $42.11	Facility		$42.11	$42.11	$42.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.17 / $43.13 / $87.86	Professional		$31.17	$43.13	$87.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $12.81 / $24.33	Professional	26	$8.35	$12.81	$24.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.99 / $30.86 / $64.80	Professional	TC	$21.99	$30.86	$64.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $48.50 / $68.98	Professional		$41.23	$48.50	$68.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $12.98 / $18.80	Professional	26	$10.80	$12.98	$18.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $29.85 / $36.22 / $51.22	Professional	TC	$29.85	$36.22	$51.22
United Facility/Professional Professional Modifier Low / Median / High Price $29.56 / $37.70 / $66.95	Professional		$29.56	$37.70	$66.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.27 / $11.55 / $19.57	Professional	26	$8.27	$11.55	$19.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.88 / $27.07 / $50.69	Professional	TC	$20.88	$27.07	$50.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.20 / $44.91 / $58.57	Professional		$28.20	$44.91	$58.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.40 / $11.52 / $15.71	Professional	26	$7.40	$11.52	$15.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $20.80 / $33.54 / $42.87	Professional	TC	$20.80	$33.54	$42.87