Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $154.88 / $478.63	Facility		$89.13	$154.88	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $9.33 / $10.96	Facility	26	$7.76	$9.33	$10.96
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $123.03 / $426.58	Facility	TC	$32.36	$123.03	$426.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $39.81 / $123.03	Professional		$9.12	$39.81	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $15.49 / $43.65	Professional	26	$8.51	$15.49	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $77.62 / $190.55	Professional	50	$26.92	$77.62	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $95.50	Professional	TC	$21.88	$39.81	$95.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $35.48 / $42.66	Professional		$10.96	$35.48	$42.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $10.72	Professional	26	$8.51	$9.55	$10.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $29.51 / $33.11	Professional	TC	$25.12	$29.51	$33.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $38.02 / $53.70	Facility		$38.02	$38.02	$53.70
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $14.79 / $14.79	Facility	26	$14.79	$14.79	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	TC	$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $35.48 / $69.18	Professional		$25.70	$35.48	$69.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.47 / $20.89	Professional	26	$7.08	$10.47	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $25.70 / $58.88	Professional	TC	$18.20	$25.70	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $41.69 / $57.54	Professional		$36.31	$41.69	$57.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.33 / $10.23 / $14.13	Professional	26	$9.33	$10.23	$14.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $31.62 / $42.66	Professional	TC	$26.92	$31.62	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $6.92 / $19.05 / $30.20	Facility		$6.92	$19.05	$30.20
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $33.88 / $58.88	Professional		$25.12	$33.88	$58.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $9.77 / $16.60	Professional	26	$6.92	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $23.99 / $44.67	Professional	TC	$17.78	$23.99	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $43.65 / $57.54	Professional		$23.99	$43.65	$57.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $10.72 / $13.80	Professional	26	$6.03	$10.72	$13.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $33.11 / $42.66	Professional	TC	$17.78	$33.11	$42.66