Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $173.78 / $467.74	Facility		$95.50	$173.78	$467.74
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $9.55 / $13.80	Facility	26	$6.92	$9.55	$13.80
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $32.36 / $144.54 / $616.60	Facility	TC	$32.36	$144.54	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $36.31 / $123.03	Professional		$8.13	$36.31	$123.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.41 / $15.14 / $42.66	Professional	26	$7.41	$15.14	$42.66
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $81.28 / $204.17	Professional	50	$17.78	$81.28	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $28.18 / $33.11 / $52.48	Professional	52	$28.18	$33.11	$52.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $39.81 / $95.50	Professional	TC	$21.88	$39.81	$95.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $7.76 / $34.67 / $43.65	Professional		$7.76	$34.67	$43.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.59 / $8.51 / $12.02	Professional	26	$7.59	$8.51	$12.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $26.92 / $34.67	Professional	TC	$23.99	$26.92	$34.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $52.48	Facility		$35.48	$35.48	$52.48
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.18 / $13.18 / $13.18	Facility	26	$13.18	$13.18	$13.18
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	TC	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $34.67 / $70.79	Professional		$25.70	$34.67	$70.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.31 / $9.77 / $18.62	Professional	26	$6.31	$9.77	$18.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.70 / $58.88	Professional	TC	$18.62	$25.70	$58.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $40.74 / $54.95	Professional		$34.67	$40.74	$54.95
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.32 / $9.12 / $12.59	Professional	26	$8.32	$9.12	$12.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.30 / $30.90 / $42.66	Professional	TC	$26.30	$30.90	$42.66
United Facility/Professional Facility Modifier Low / Median / High Price $6.61 / $16.98 / $29.51	Facility		$6.61	$16.98	$29.51
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $33.88 / $60.26	Professional		$23.99	$33.88	$60.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $8.71 / $14.79	Professional	26	$6.61	$8.71	$14.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $25.12 / $44.67	Professional	TC	$17.38	$25.12	$44.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $42.66 / $56.23	Professional		$24.55	$42.66	$56.23
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $9.55 / $12.30	Professional	26	$5.62	$9.55	$12.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $32.36 / $44.67	Professional	TC	$19.05	$32.36	$44.67