Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $173.78 / $323.59	Facility		$93.33	$173.78	$323.59
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 $30.20 / $169.82 / $363.08	Facility	TC	$30.20	$169.82	$363.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $36.31 / $134.90	Professional		$8.91	$36.31	$134.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $15.85 / $40.74	Professional	26	$7.94	$15.85	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.42 / $77.62 / $213.80	Professional	50	$20.42	$77.62	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $40.74 / $95.50	Professional	TC	$20.42	$40.74	$95.50
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 $26.30 / $36.31 / $74.13	Professional		$26.30	$36.31	$74.13
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 $19.50 / $27.54 / $57.54	Professional	TC	$19.50	$27.54	$57.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $39.81 / $52.48	Professional		$34.67	$39.81	$52.48
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 $26.30 / $30.20 / $39.81	Professional	TC	$26.30	$30.20	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $19.05 / $31.62	Facility		$6.31	$19.05	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $32.36 / $57.54	Professional		$25.70	$32.36	$57.54
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 $18.62 / $24.55 / $41.69	Professional	TC	$18.62	$24.55	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $40.74 / $53.70	Professional		$26.30	$40.74	$53.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $10.00 / $12.88	Professional	26	$6.46	$10.00	$12.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $30.90 / $40.74	Professional	TC	$19.50	$30.90	$40.74