Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.91 / $185.72 / $329.42	Facility		$87.91	$185.72	$329.42
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $10.21 / $14.94	Facility	26	$7.50	$10.21	$14.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $24.23 / $168.59 / $265.14	Facility	TC	$24.23	$168.59	$265.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.97 / $39.06 / $141.60	Professional		$9.97	$39.06	$141.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.89 / $41.50	Professional	26	$7.79	$9.89	$41.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $36.85 / $88.72 / $184.65	Professional	50	$36.85	$88.72	$184.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.48 / $26.66 / $64.93	Professional	TC	$21.48	$26.66	$64.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $37.74 / $47.93	Professional		$35.67	$37.74	$47.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.61 / $10.69 / $13.58	Professional	26	$9.61	$10.69	$13.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.98 / $27.05 / $34.36	Professional	TC	$24.98	$27.05	$34.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $41.29 / $79.09	Professional		$28.07	$41.29	$79.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.81 / $10.58 / $20.30	Professional	26	$6.81	$10.58	$20.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.77 / $30.12 / $60.34	Professional	TC	$20.77	$30.12	$60.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $36.86 / $44.50 / $61.95	Professional		$36.86	$44.50	$61.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $10.15 / $14.43	Professional	26	$8.68	$10.15	$14.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.10 / $33.97 / $47.52	Professional	TC	$28.10	$33.97	$47.52
United Facility/Professional Professional Modifier Low / Median / High Price $26.65 / $34.81 / $60.99	Professional		$26.65	$34.81	$60.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.25 / $9.38 / $18.11	Professional	26	$7.25	$9.38	$18.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.62 / $25.05 / $45.63	Professional	TC	$19.62	$25.05	$45.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.10 / $40.45 / $52.67	Professional		$28.10	$40.45	$52.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.66 / $9.36 / $12.77	Professional	26	$6.66	$9.36	$12.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $21.44 / $31.22 / $39.92	Professional	TC	$21.44	$31.22	$39.92