Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $120.23 / $190.55	Facility		$38.90	$120.23	$190.55
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 $21.88 / $91.20 / $309.03	Facility	TC	$21.88	$91.20	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $48.98 / $141.25	Professional		$28.18	$48.98	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $15.14 / $36.31	Professional	26	$7.59	$15.14	$36.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $32.36 / $74.13	Professional	TC	$19.95	$32.36	$74.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $33.11 / $38.02	Professional		$8.91	$33.11	$38.02
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $7.94 / $10.23	Professional	26	$7.94	$7.94	$10.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $28.18 / $31.62	Professional	TC	$23.99	$28.18	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $51.29	Facility		$38.02	$38.02	$51.29
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 $38.02 / $38.02 / $38.02	Facility	TC	$38.02	$38.02	$38.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $34.67 / $67.61	Professional		$25.12	$34.67	$67.61
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.55 / $19.05	Professional	26	$6.61	$9.55	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $25.70 / $57.54	Professional	TC	$17.78	$25.70	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $38.02 / $51.29	Professional		$32.36	$38.02	$51.29
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 $23.99 / $28.18 / $38.90	Professional	TC	$23.99	$28.18	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $19.05 / $30.20	Facility		$6.31	$19.05	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $31.62 / $56.23	Professional		$24.55	$31.62	$56.23
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 $17.78 / $22.91 / $42.66	Professional	TC	$17.78	$22.91	$42.66
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $38.90 / $53.70	Professional		$23.99	$38.90	$53.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.89 / $10.00 / $12.88	Professional	26	$5.89	$10.00	$12.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $29.51 / $40.74	Professional	TC	$17.78	$29.51	$40.74