Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $173.78 / $371.54	Facility		$93.33	$173.78	$371.54
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.61 / $7.94 / $9.33	Facility	26	$6.61	$7.94	$9.33
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.70 / $147.91 / $436.52	Facility	TC	$25.70	$147.91	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.32 / $34.67 / $114.82	Professional		$8.32	$34.67	$114.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.08 / $15.14 / $43.65	Professional	26	$7.08	$15.14	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $17.78 / $72.44 / $162.18	Professional	50	$17.78	$72.44	$162.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $34.67 / $81.28	Professional	TC	$19.05	$34.67	$81.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $8.13 / $29.51 / $37.15	Professional		$8.13	$29.51	$37.15
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.24 / $7.41 / $9.33	Professional	26	$7.24	$7.41	$9.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.89 / $25.12 / $31.62	Professional	TC	$20.89	$25.12	$31.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $48.98	Facility		$35.48	$35.48	$48.98
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.59 / $12.59 / $12.59	Facility	26	$12.59	$12.59	$12.59
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $37.15 / $37.15 / $37.15	Facility	TC	$37.15	$37.15	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $32.36 / $63.10	Professional		$23.44	$32.36	$63.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.33 / $17.78	Professional	26	$6.03	$9.33	$17.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.98 / $24.55 / $53.70	Professional	TC	$16.98	$24.55	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $37.15 / $50.12	Professional		$31.62	$37.15	$50.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.71 / $12.02	Professional	26	$7.94	$8.71	$12.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $28.18 / $38.90	Professional	TC	$23.99	$28.18	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $16.98 / $27.54	Facility		$6.31	$16.98	$27.54
United Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $30.90 / $56.23	Professional		$22.91	$30.90	$56.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.46 / $8.32 / $14.45	Professional	26	$6.46	$8.32	$14.45
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $22.91 / $41.69	Professional	TC	$16.22	$22.91	$41.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $22.91 / $38.90 / $52.48	Professional		$22.91	$38.90	$52.48
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.37 / $9.12 / $11.75	Professional	26	$5.37	$9.12	$11.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.38 / $29.51 / $40.74	Professional	TC	$17.38	$29.51	$40.74