Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $173.78 / $489.78	Facility		$48.98	$173.78	$489.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $8.71 / $10.00	Facility	26	$7.24	$8.71	$10.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $21.38 / $107.15 / $398.11	Facility	TC	$21.38	$107.15	$398.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $39.81 / $120.23	Professional		$22.91	$39.81	$120.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.76 / $11.48 / $34.67	Professional	26	$7.76	$11.48	$34.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $27.54 / $67.61	Professional	TC	$15.85	$27.54	$67.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $10.00 / $28.84 / $34.67	Professional		$10.00	$28.84	$34.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $10.00	Professional	26	$7.94	$8.91	$10.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $22.91 / $25.70	Professional	TC	$19.05	$22.91	$25.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $43.65	Facility		$35.48	$35.48	$43.65
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $13.49 / $13.49	Facility	26	$13.49	$13.49	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $30.20 / $30.20 / $30.20	Facility	TC	$30.20	$30.20	$30.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $32.36 / $64.57	Professional		$22.39	$32.36	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.77 / $19.50	Professional	26	$6.61	$9.77	$19.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.49 / $22.91 / $45.71	Professional	TC	$15.49	$22.91	$45.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $33.11 / $44.67	Professional		$29.51	$33.11	$44.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $13.18	Professional	26	$8.51	$9.55	$13.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.44 / $31.62	Professional	TC	$19.95	$23.44	$31.62
United Facility/Professional Facility Modifier Low / Median / High Price $6.46 / $16.98 / $27.54	Facility		$6.46	$16.98	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $28.84 / $53.70	Professional		$21.88	$28.84	$53.70
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $15.49	Professional	26	$6.61	$9.12	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $19.95 / $39.81	Professional	TC	$15.14	$19.95	$39.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.67 / $45.71	Professional		$25.12	$34.67	$45.71
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $10.00 / $12.88	Professional	26	$7.41	$10.00	$12.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $24.55 / $33.11	Professional	TC	$18.20	$24.55	$33.11