Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.09 / $210.02 / $429.48	Facility		$93.09	$210.02	$429.48
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 $31.12 / $193.32 / $448.96	Facility	TC	$31.12	$193.32	$448.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.18 / $39.95 / $145.00	Professional		$11.18	$39.95	$145.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.54 / $39.31	Professional	26	$7.33	$11.54	$39.31
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $20.14 / $82.78 / $174.68	Professional	50	$20.14	$82.78	$174.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $33.85 / $140.00	Professional	TC	$22.91	$33.85	$140.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $36.27 / $41.45	Professional		$32.22	$36.27	$41.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $11.23	Professional	26	$8.38	$9.31	$11.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.93 / $26.96 / $32.09	Professional	TC	$22.93	$26.96	$32.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $35.61 / $35.61	Facility		$35.61	$35.61	$35.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.36 / $38.07 / $74.94	Professional		$28.36	$38.07	$74.94
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.85 / $19.23	Professional	26	$6.55	$9.85	$19.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.39 / $28.71 / $64.80	Professional	TC	$21.39	$28.71	$64.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.07 / $45.82 / $63.89	Professional		$36.07	$45.82	$63.89
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 $28.38 / $35.22 / $49.98	Professional	TC	$28.38	$35.22	$49.98
United Facility/Professional Facility Modifier Low / Median / High Price $7.62 / $17.70 / $53.34	Facility		$7.62	$17.70	$53.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.00 / $37.40 / $62.37	Professional		$25.00	$37.40	$62.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $8.58 / $16.11	Professional	26	$6.27	$8.58	$16.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $26.35 / $46.91	Professional	TC	$18.35	$26.35	$46.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.43 / $55.14	Professional		$24.55	$42.43	$55.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.35 / $9.00 / $12.27	Professional	26	$5.35	$9.00	$12.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.20 / $33.54 / $42.87	Professional	TC	$19.20	$33.54	$42.87