Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $281.84 / $467.74	Facility		$89.13	$281.84	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.33 / $10.96 / $12.88	Facility	26	$9.33	$10.96	$12.88
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $123.03 / $239.88 / $467.74	Facility	TC	$123.03	$239.88	$467.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $58.88 / $162.18	Professional		$34.67	$58.88	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.12 / $16.22 / $40.74	Professional	26	$9.12	$16.22	$40.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $26.92 / $120.23 / $204.17	Professional	50	$26.92	$120.23	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	52	$72.44	$72.44	$72.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $37.15 / $79.43	Professional	TC	$25.12	$37.15	$79.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $41.69 / $48.98	Professional		$35.48	$41.69	$48.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $10.23 / $11.48 / $12.88	Professional	26	$10.23	$11.48	$12.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $31.62 / $40.74	Professional	TC	$30.90	$31.62	$40.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.57 / $64.57 / $64.57	Facility		$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	26	$17.38	$17.38	$17.38
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $47.86 / $47.86 / $47.86	Facility	TC	$47.86	$47.86	$47.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $44.67 / $89.13	Professional		$31.62	$44.67	$89.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $12.59 / $23.99	Professional	26	$8.32	$12.59	$23.99
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $33.11 / $67.61	Professional	TC	$23.44	$33.11	$67.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $48.98 / $67.61	Professional		$44.67	$48.98	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.96 / $12.30 / $16.60	Professional	26	$10.96	$12.30	$16.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $37.15 / $50.12	Professional	TC	$33.11	$37.15	$50.12
United Facility/Professional Facility Modifier Low / Median / High Price $8.71 / $24.55 / $39.81	Facility		$8.71	$24.55	$39.81
United Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $40.74 / $74.13	Professional		$32.36	$40.74	$74.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.91 / $11.48 / $19.95	Professional	26	$8.91	$11.48	$19.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $28.84 / $53.70	Professional	TC	$23.44	$28.84	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $51.29 / $67.61	Professional		$34.67	$51.29	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.71 / $12.88 / $16.22	Professional	26	$8.71	$12.88	$16.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $38.02 / $51.29	Professional	TC	$25.70	$38.02	$51.29