Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.93 / $146.69 / $233.92	Facility		$51.93	$146.69	$233.92
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.95 / $8.40 / $13.83	Facility	26	$6.95	$8.40	$13.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.99 / $117.98 / $318.98	Facility	TC	$22.99	$117.98	$318.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.43 / $29.67 / $116.05	Professional		$18.43	$29.67	$116.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $9.48 / $35.76	Professional	26	$6.95	$9.48	$35.76
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $64.89 / $71.27 / $82.90	Professional	50	$64.89	$71.27	$82.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.94 / $21.44 / $50.98	Professional	TC	$17.94	$21.44	$50.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.56 / $31.73 / $36.27	Professional		$28.56	$31.73	$36.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.74 / $8.59 / $9.83	Professional	26	$7.74	$8.59	$9.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.82 / $23.14 / $26.44	Professional	TC	$20.82	$23.14	$26.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $33.90 / $33.90	Facility		$33.90	$33.90	$33.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.37 / $33.03 / $65.06	Professional		$23.37	$33.03	$65.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.29 / $9.24 / $17.67	Professional	26	$6.29	$9.24	$17.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $24.72 / $47.71	Professional	TC	$17.14	$24.72	$47.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $35.88 / $51.02	Professional		$30.53	$35.88	$51.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $9.36 / $13.37	Professional	26	$8.11	$9.36	$13.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $26.64 / $37.65	Professional	TC	$22.39	$26.64	$37.65
United Facility/Professional Facility Modifier Low / Median / High Price $6.66 / $19.60 / $45.61	Facility		$6.66	$19.60	$45.61
United Facility/Professional Professional Modifier Low / Median / High Price $21.66 / $28.87 / $50.88	Professional		$21.66	$28.87	$50.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $5.76 / $8.66 / $15.11	Professional	26	$5.76	$8.66	$15.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.90 / $20.21 / $36.02	Professional	TC	$15.90	$20.21	$36.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.74 / $33.22 / $43.31	Professional		$21.74	$33.22	$43.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.80 / $8.64 / $11.77	Professional	26	$5.80	$8.64	$11.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.94 / $24.67 / $31.53	Professional	TC	$15.94	$24.67	$31.53