Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.04 / $184.51 / $370.44	Facility		$86.04	$184.51	$370.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.95 / $9.41 / $13.83	Facility	26	$6.95	$9.41	$13.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $28.59 / $161.97 / $418.40	Facility	TC	$28.59	$161.97	$418.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $10.73 / $35.42 / $139.00	Professional		$10.73	$35.42	$139.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.95 / $10.07 / $41.00	Professional	26	$6.95	$10.07	$41.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.18 / $75.15 / $208.50	Professional	50	$21.18	$75.15	$208.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.40 / $16.61 / $40.94	Professional	52	$14.40	$16.61	$40.94
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.46 / $26.00 / $105.00	Professional	TC	$19.46	$26.00	$105.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.15 / $37.19 / $45.93	Professional		$31.15	$37.19	$45.93
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.44 / $10.49 / $13.32	Professional	26	$9.44	$10.49	$13.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.72 / $26.70 / $33.52	Professional	TC	$21.72	$26.70	$33.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $35.15 / $35.15	Facility		$35.15	$35.15	$35.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.62 / $36.61 / $70.95	Professional		$26.62	$36.61	$70.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.30 / $10.11 / $18.72	Professional	26	$6.30	$10.11	$18.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.27 / $27.83 / $58.86	Professional	TC	$20.27	$27.83	$58.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $41.70 / $60.27	Professional		$33.22	$41.70	$60.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.11 / $10.00 / $15.27	Professional	26	$8.11	$10.00	$15.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.54 / $32.47 / $46.90	Professional	TC	$25.54	$32.47	$46.90
United Facility/Professional Professional Modifier Low / Median / High Price $23.69 / $33.92 / $65.50	Professional		$23.69	$33.92	$65.50
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.60 / $9.16 / $17.35	Professional	26	$6.60	$9.16	$17.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.46 / $25.47 / $59.72	Professional	TC	$16.46	$25.47	$59.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $38.61 / $50.21	Professional		$24.56	$38.61	$50.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.64 / $8.64 / $11.77	Professional	26	$5.64	$8.64	$11.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.91 / $30.07 / $38.43	Professional	TC	$18.91	$30.07	$38.43