Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.11 / $153.74 / $310.64	Facility		$80.11	$153.74	$310.64
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.65 / $9.02 / $13.23	Facility	26	$6.65	$9.02	$13.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.54 / $116.14 / $328.01	Facility	TC	$23.54	$116.14	$328.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.07 / $30.93 / $116.06	Professional		$13.07	$30.93	$116.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $9.86 / $38.00	Professional	26	$6.89	$9.86	$38.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.30 / $38.18 / $145.58	Professional	50	$18.30	$38.18	$145.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.21 / $22.29 / $60.98	Professional	TC	$18.21	$22.29	$60.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.64 / $30.86 / $35.28	Professional		$29.64	$30.86	$35.28
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $8.94 / $10.24	Professional	26	$8.06	$8.94	$10.24
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.58 / $21.91 / $25.04	Professional	TC	$21.58	$21.91	$25.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.31 / $34.31 / $34.31	Facility		$34.31	$34.31	$34.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.49 / $33.45 / $63.62	Professional		$23.49	$33.45	$63.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.10 / $17.68	Professional	26	$6.03	$9.10	$17.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.05 / $24.65 / $48.46	Professional	TC	$17.05	$24.65	$48.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.26 / $35.88 / $51.02	Professional		$30.26	$35.88	$51.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.35 / $14.12	Professional	26	$7.75	$9.35	$14.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.75 / $27.05 / $38.27	Professional	TC	$21.75	$27.05	$38.27
United Facility/Professional Professional Modifier Low / Median / High Price $21.92 / $29.23 / $53.27	Professional		$21.92	$29.23	$53.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $8.66 / $14.86	Professional	26	$6.03	$8.66	$14.86
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.07 / $20.57 / $35.44	Professional	TC	$16.07	$20.57	$35.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $21.47 / $33.22 / $43.31	Professional		$21.47	$33.22	$43.31
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.48 / $8.27 / $11.28	Professional	26	$5.48	$8.27	$11.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.99 / $25.05 / $32.03	Professional	TC	$15.99	$25.05	$32.03