Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $141.25 / $316.23	Facility		$75.86	$141.25	$316.23
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $7.94 / $9.33	Facility	26	$6.61	$7.94	$9.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.44 / $120.23 / $331.13	Facility	TC	$23.44	$120.23	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.71 / $32.36 / $109.65	Professional		$8.71	$32.36	$109.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.14 / $39.81	Professional	26	$7.08	$15.14	$39.81
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $15.49 / $58.88 / $251.19	Professional	50	$15.49	$58.88	$251.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $32.36 / $75.86	Professional	TC	$18.20	$32.36	$75.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $10.96 / $30.20 / $34.67	Professional		$10.96	$30.20	$34.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $8.13 / $8.91	Professional	26	$7.24	$8.13	$8.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.38 / $22.39 / $28.84	Professional	TC	$21.38	$22.39	$28.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $45.71	Facility		$34.67	$34.67	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	26	$12.59	$12.59	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	TC	$33.88	$33.88	$33.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $31.62 / $63.10	Professional		$22.91	$31.62	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.91 / $17.38	Professional	26	$6.03	$8.91	$17.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $51.29	Professional	TC	$16.22	$22.91	$51.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $33.88 / $46.77	Professional		$30.20	$33.88	$46.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.71 / $12.02	Professional	26	$7.94	$8.71	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $25.12 / $34.67	Professional	TC	$21.88	$25.12	$34.67
United Facility/Professional Facility Modifier Low / Median / High Price $5.75 / $16.98 / $26.92	Facility		$5.75	$16.98	$26.92
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $29.51 / $51.29	Professional		$22.39	$29.51	$51.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.71 / $14.79	Professional	26	$6.03	$8.71	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $20.89 / $38.90	Professional	TC	$16.22	$20.89	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $35.48 / $47.86	Professional		$21.38	$35.48	$47.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.50 / $9.12 / $11.75	Professional	26	$5.50	$9.12	$11.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $26.30 / $36.31	Professional	TC	$15.85	$26.30	$36.31