Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.32 / $182.52 / $309.24	Facility		$91.32	$182.52	$309.24
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $9.81 / $14.38	Facility	26	$7.23	$9.81	$14.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.77 / $191.47 / $477.34	Facility	TC	$28.77	$191.47	$477.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $36.40 / $145.00	Professional		$17.98	$36.40	$145.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $10.88 / $36.38	Professional	26	$7.33	$10.88	$36.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.14 / $46.15 / $90.93	Professional	50	$20.14	$46.15	$90.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.84 / $27.99 / $80.20	Professional	TC	$21.84	$27.99	$80.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $37.29 / $42.63	Professional		$33.57	$37.29	$42.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $10.64	Professional	26	$8.38	$9.31	$10.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.94 / $27.99 / $31.99	Professional	TC	$24.94	$27.99	$31.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.82 / $37.82 / $37.82	Facility		$37.82	$37.82	$37.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $39.63 / $75.66	Professional		$26.30	$39.63	$75.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.96 / $19.23	Professional	26	$6.55	$9.96	$19.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.75 / $29.18 / $55.14	Professional	TC	$19.75	$29.18	$55.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $40.56 / $56.49	Professional		$34.00	$40.56	$56.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $9.74 / $14.70	Professional	26	$8.44	$9.74	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.53 / $30.81 / $42.59	Professional	TC	$25.53	$30.81	$42.59
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $31.53 / $57.22	Professional		$25.12	$31.53	$57.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.56 / $8.83 / $15.30	Professional	26	$6.56	$8.83	$15.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $24.08 / $41.92	Professional	TC	$18.28	$24.08	$41.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $26.19 / $37.03 / $48.24	Professional		$26.19	$37.03	$48.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.52 / $9.00 / $12.27	Professional	26	$6.52	$9.00	$12.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.67 / $28.14 / $35.97	Professional	TC	$19.67	$28.14	$35.97