Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.32 / $184.51 / $354.72	Facility		$91.32	$184.51	$354.72
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.65 / $9.02 / $13.23	Facility	26	$6.65	$9.02	$13.23
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.84 / $170.76 / $467.84	Facility	TC	$25.84	$170.76	$467.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $13.61 / $34.69 / $127.00	Professional		$13.61	$34.69	$127.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.89 / $9.74 / $37.15	Professional	26	$6.89	$9.74	$37.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.18 / $46.15 / $147.51	Professional	50	$21.18	$46.15	$147.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.59 / $23.70 / $98.02	Professional	TC	$17.59	$23.70	$98.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $33.61 / $38.43	Professional		$29.21	$33.61	$38.43
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $10.64	Professional	26	$8.38	$9.31	$10.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.34 / $24.31 / $27.79	Professional	TC	$20.34	$24.31	$27.79
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 $24.82 / $34.34 / $63.79	Professional		$24.82	$34.34	$63.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.50 / $17.93	Professional	26	$6.03	$9.50	$17.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $18.02 / $26.35 / $53.66	Professional	TC	$18.02	$26.35	$53.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.52 / $38.78 / $55.34	Professional		$30.52	$38.78	$55.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.35 / $14.70	Professional	26	$7.75	$9.35	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.11 / $29.97 / $42.59	Professional	TC	$23.11	$29.97	$42.59
United Facility/Professional Professional Modifier Low / Median / High Price $21.93 / $31.04 / $52.47	Professional		$21.93	$31.04	$52.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.41 / $8.30 / $14.05	Professional	26	$6.41	$8.30	$14.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.77 / $22.46 / $41.44	Professional	TC	$15.77	$22.46	$41.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.85 / $35.90 / $46.76	Professional		$22.85	$35.90	$46.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.40 / $8.27 / $11.28	Professional	26	$5.40	$8.27	$11.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.45 / $27.75 / $35.47	Professional	TC	$17.45	$27.75	$35.47