Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $239.88 / $436.52	Facility		$97.72	$239.88	$436.52
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.76 / $10.72 / $15.49	Facility	26	$7.76	$10.72	$15.49
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $39.81 / $263.03 / $489.78	Facility	TC	$39.81	$263.03	$489.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $9.12 / $45.71 / $162.18	Professional		$9.12	$45.71	$162.18
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $17.78 / $46.77	Professional	26	$8.51	$17.78	$46.77
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.05 / $79.43 / $208.93	Professional	50	$19.05	$79.43	$208.93
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $50.12 / $123.03	Professional	TC	$26.92	$50.12	$123.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $9.55 / $41.69 / $50.12	Professional		$9.55	$41.69	$50.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.12 / $11.48	Professional	26	$8.51	$9.12	$11.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $31.62 / $36.31 / $38.90	Professional	TC	$31.62	$36.31	$38.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $63.10	Facility		$38.90	$38.90	$63.10
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $14.79 / $14.79 / $14.79	Facility	26	$14.79	$14.79	$14.79
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	TC	$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $40.74 / $83.18	Professional		$30.20	$40.74	$83.18
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $10.47 / $20.89	Professional	26	$7.08	$10.47	$20.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $30.90 / $70.79	Professional	TC	$22.39	$30.90	$70.79
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $50.12 / $67.61	Professional		$42.66	$50.12	$67.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $9.55 / $10.72 / $14.79	Professional	26	$9.55	$10.72	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $38.90 / $53.70	Professional	TC	$33.11	$38.90	$53.70
United Facility/Professional Facility Modifier Low / Median / High Price $6.92 / $19.50 / $34.67	Facility		$6.92	$19.50	$34.67
United Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $39.81 / $70.79	Professional		$27.54	$39.81	$70.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $9.77 / $16.60	Professional	26	$7.24	$9.77	$16.60
United Facility/Professional Professional Modifier TC Low / Median / High Price $20.42 / $30.20 / $53.70	Professional	TC	$20.42	$30.20	$53.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $67.61	Professional		$28.84	$52.48	$67.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.17 / $11.22 / $14.13	Professional	26	$6.17	$11.22	$14.13
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $40.74 / $53.70	Professional	TC	$22.39	$40.74	$53.70