Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $82.80 / $175.02 / $401.92	Facility		$82.80	$175.02	$401.92
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $9.81 / $14.38	Facility	26	$7.23	$9.81	$14.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.20 / $108.35 / $350.92	Facility	TC	$21.20	$108.35	$350.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.28 / $30.35 / $119.02	Professional		$24.28	$30.35	$119.02
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.50 / $9.64 / $30.40	Professional	26	$7.50	$9.64	$30.40
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.35 / $19.42 / $55.98	Professional	TC	$16.35	$19.42	$55.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.65 / $28.95 / $33.08	Professional		$28.65	$28.95	$33.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.07 / $10.08 / $12.20	Professional	26	$9.07	$10.08	$12.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.87 / $18.87 / $22.51	Professional	TC	$18.87	$18.87	$22.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $35.15 / $35.15	Facility		$35.15	$35.15	$35.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.48 / $34.02 / $66.53	Professional		$22.48	$34.02	$66.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $10.02 / $19.30	Professional	26	$6.55	$10.02	$19.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $24.66 / $49.27	Professional	TC	$15.94	$24.66	$49.27
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.12 / $34.15 / $48.46	Professional		$29.12	$34.15	$48.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $10.16 / $14.70	Professional	26	$8.44	$10.16	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.54 / $24.56 / $34.56	Professional	TC	$19.54	$24.56	$34.56
United Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $31.76 / $57.13	Professional		$21.51	$31.76	$57.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $8.64 / $15.30	Professional	26	$6.47	$8.64	$15.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.53 / $20.51 / $43.84	Professional	TC	$14.53	$20.51	$43.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.30 / $31.63 / $41.34	Professional		$23.30	$31.63	$41.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.78 / $9.00 / $12.27	Professional	26	$6.78	$9.00	$12.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.52 / $22.74 / $29.07	Professional	TC	$16.52	$22.74	$29.07