Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.17 / $115.50 / $192.08	Facility		$35.17	$115.50	$192.08
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 $26.20 / $83.42 / $234.04	Facility	TC	$26.20	$83.42	$234.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.22 / $35.35 / $142.01	Professional		$27.22	$35.35	$142.01
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.23 / $8.72 / $34.85	Professional	26	$7.23	$8.72	$34.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $24.03 / $64.13	Professional	TC	$19.14	$24.03	$64.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $33.96 / $38.82	Professional		$31.64	$33.96	$38.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $10.64	Professional	26	$8.38	$9.31	$10.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $24.66 / $28.18	Professional	TC	$22.33	$24.66	$28.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.82 / $37.82 / $37.82	Facility		$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.01 / $36.99 / $68.51	Professional		$26.01	$36.99	$68.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.85 / $19.23	Professional	26	$6.55	$9.85	$19.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.70 / $27.63 / $54.40	Professional	TC	$18.70	$27.63	$54.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.71 / $39.99 / $56.49	Professional		$31.71	$39.99	$56.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $9.74 / $14.70	Professional	26	$8.44	$9.74	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $30.39 / $42.59	Professional	TC	$23.92	$30.39	$42.59
United Facility/Professional Professional Modifier Low / Median / High Price $23.94 / $33.29 / $67.92	Professional		$23.94	$33.29	$67.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.02 / $15.31	Professional	26	$6.55	$9.02	$15.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.32 / $22.74 / $42.49	Professional	TC	$17.32	$22.74	$42.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.80 / $37.03 / $48.24	Professional		$23.80	$37.03	$48.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.93 / $9.00 / $12.27	Professional	26	$5.93	$9.00	$12.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.87 / $28.14 / $35.97	Professional	TC	$17.87	$28.14	$35.97