Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $218.78 / $512.86	Facility		$120.23	$218.78	$512.86
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $10.00 / $190.55	Facility	26	$7.24	$10.00	$190.55
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $190.55 / $407.38	Facility	TC	$39.81	$190.55	$407.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $42.66 / $151.36	Professional		$9.12	$42.66	$151.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.98 / $42.66	Professional	26	$7.94	$16.98	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $79.43 / $204.17	Professional	50	$17.78	$79.43	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $50.12 / $109.65	Professional	TC	$26.92	$50.12	$109.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $7.94 / $38.90 / $48.98	Professional		$7.94	$38.90	$48.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.71 / $10.96	Professional	26	$7.94	$8.71	$10.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $38.02 / $39.81	Professional	TC	$30.20	$38.02	$39.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $64.57	Facility		$35.48	$35.48	$64.57
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 $51.29 / $51.29 / $51.29	Facility	TC	$51.29	$51.29	$51.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $40.74 / $83.18	Professional		$29.51	$40.74	$83.18
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 $22.39 / $31.62 / $74.13	Professional	TC	$22.39	$31.62	$74.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $50.12 / $69.18	Professional		$43.65	$50.12	$69.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $10.00 / $13.49	Professional	26	$8.91	$10.00	$13.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.81 / $54.95	Professional	TC	$33.11	$39.81	$54.95
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $17.78 / $35.48	Facility		$6.31	$17.78	$35.48
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $38.90 / $69.18	Professional		$27.54	$38.90	$69.18
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 $20.42 / $30.20 / $53.70	Professional	TC	$20.42	$30.20	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $52.48 / $67.61	Professional		$28.18	$52.48	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $10.47 / $13.18	Professional	26	$5.62	$10.47	$13.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $41.69 / $54.95	Professional	TC	$22.91	$41.69	$54.95