Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.24 / $161.30 / $408.38	Facility		$86.24	$161.30	$408.38
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.80 / $10.60 / $15.54	Facility	26	$7.80	$10.60	$15.54
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $31.56 / $130.15 / $379.36	Facility	TC	$31.56	$130.15	$379.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $39.29 / $139.61	Professional		$10.52	$39.29	$139.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.78 / $40.99	Professional	26	$8.11	$10.78	$40.99
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.86 / $33.27 / $174.31	Professional	50	$17.86	$33.27	$174.31
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.14 / $25.78 / $104.00	Professional	TC	$19.14	$25.78	$104.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.81 / $35.24 / $43.53	Professional		$33.81	$35.24	$43.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.66 / $10.84 / $13.12	Professional	26	$9.66	$10.84	$13.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.97 / $24.40 / $28.77	Professional	TC	$22.97	$24.40	$28.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $38.22 / $38.22	Facility		$38.22	$38.22	$38.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.89 / $37.71 / $69.73	Professional		$26.89	$37.71	$69.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.07 / $10.83 / $20.83	Professional	26	$7.07	$10.83	$20.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $27.63 / $58.11	Professional	TC	$19.05	$27.63	$58.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $42.44 / $60.10	Professional		$33.57	$42.44	$60.10
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.14 / $10.98 / $15.29	Professional	26	$9.14	$10.98	$15.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.15 / $32.04 / $44.02	Professional	TC	$25.15	$32.04	$44.02
United Facility/Professional Professional Modifier Low / Median / High Price $24.84 / $33.56 / $61.18	Professional		$24.84	$33.56	$61.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $9.55 / $16.70	Professional	26	$7.18	$9.55	$16.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.20 / $23.82 / $43.13	Professional	TC	$17.20	$23.82	$43.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $39.29 / $51.20	Professional		$23.78	$39.29	$51.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.72 / $13.26	Professional	26	$6.03	$9.72	$13.26
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.73 / $29.68 / $37.94	Professional	TC	$17.73	$29.68	$37.94