Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.08 / $205.53 / $455.84	Facility		$44.08	$205.53	$455.84
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $9.23 / $11.07 / $12.64	Facility	26	$9.23	$11.07	$12.64
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.01 / $190.61 / $578.20	Facility	TC	$33.01	$190.61	$578.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.89 / $41.60 / $158.37	Professional		$35.89	$41.60	$158.37
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $9.35 / $11.70 / $36.54	Professional	26	$9.35	$11.70	$36.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.57 / $30.22 / $73.72	Professional	TC	$25.57	$30.22	$73.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $44.21 / $56.15	Professional		$42.14	$44.21	$56.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.75 / $13.06 / $16.59	Professional	26	$11.75	$13.06	$16.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.56 / $31.15 / $39.56	Professional	TC	$30.56	$31.15	$39.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $47.88 / $93.11	Professional		$32.90	$47.88	$93.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.36 / $12.96 / $24.98	Professional	26	$8.36	$12.96	$24.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.01 / $35.38 / $68.52	Professional	TC	$24.01	$35.38	$68.52
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.74 / $51.51 / $72.06	Professional		$42.74	$51.51	$72.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $10.69 / $12.51 / $17.76	Professional	26	$10.69	$12.51	$17.76
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.91 / $38.58 / $54.30	Professional	TC	$31.91	$38.58	$54.30
United Facility/Professional Professional Modifier Low / Median / High Price $32.54 / $42.47 / $68.31	Professional		$32.54	$42.47	$68.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $8.93 / $11.55 / $19.73	Professional	26	$8.93	$11.55	$19.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.47 / $29.08 / $64.79	Professional	TC	$23.47	$29.08	$64.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $34.38 / $46.83 / $61.05	Professional		$34.38	$46.83	$61.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $8.66 / $11.52 / $15.71	Professional	26	$8.66	$11.52	$15.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.72 / $35.46 / $45.33	Professional	TC	$25.72	$35.46	$45.33