Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.75 / $206.36 / $374.82	Facility		$85.75	$206.36	$374.82
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 $34.29 / $205.38 / $394.85	Facility	TC	$34.29	$205.38	$394.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $45.00 / $159.00	Professional		$35.54	$45.00	$159.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.59 / $13.83 / $42.00	Professional	26	$9.59	$13.83	$42.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.73 / $32.01 / $85.31	Professional	TC	$25.73	$32.01	$85.31
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $40.60 / $51.56	Professional		$37.72	$40.60	$51.56
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $12.68 / $15.83	Professional	26	$11.41	$12.68	$15.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.61 / $27.92 / $35.46	Professional	TC	$26.61	$27.92	$35.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.26 / $45.26 / $45.26	Facility		$45.26	$45.26	$45.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.25 / $45.68 / $88.60	Professional		$31.25	$45.68	$88.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.35 / $12.86 / $24.33	Professional	26	$8.35	$12.86	$24.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.08 / $33.47 / $65.54	Professional	TC	$23.08	$33.47	$65.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $41.23 / $48.58 / $69.59	Professional		$41.23	$48.58	$69.59
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.80 / $12.98 / $19.39	Professional	26	$10.80	$12.98	$19.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.41 / $36.22 / $51.84	Professional	TC	$30.41	$36.22	$51.84
United Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $38.61 / $66.31	Professional		$30.90	$38.61	$66.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.10 / $11.08 / $19.57	Professional	26	$8.10	$11.08	$19.57
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.11 / $27.18 / $56.16	Professional	TC	$22.11	$27.18	$56.16
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $29.69 / $44.91 / $58.57	Professional		$29.69	$44.91	$58.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $11.52 / $15.71	Professional	26	$7.79	$11.52	$15.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.90 / $33.54 / $42.87	Professional	TC	$21.90	$33.54	$42.87