Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.79 / $172.48 / $368.82	Facility		$37.79	$172.48	$368.82
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.95 / $8.40 / $13.83	Facility	26	$6.95	$8.40	$13.83
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $22.14 / $112.45 / $334.02	Facility	TC	$22.14	$112.45	$334.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.27 / $31.58 / $143.19	Professional		$17.27	$31.58	$143.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.00 / $9.15 / $35.74	Professional	26	$7.00	$9.15	$35.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $67.72 / $67.72 / $73.51	Professional	50	$67.72	$67.72	$73.51
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $13.77 / $15.79 / $38.78	Professional	52	$13.77	$15.79	$38.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.53 / $23.10 / $56.63	Professional	TC	$18.53	$23.10	$56.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $33.94 / $38.79	Professional		$27.31	$33.94	$38.79
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.06 / $8.94 / $10.78	Professional	26	$8.06	$8.94	$10.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.21 / $24.99 / $28.56	Professional	TC	$19.21	$24.99	$28.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.86 / $33.86 / $33.86	Facility		$33.86	$33.86	$33.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.18 / $34.72 / $66.06	Professional		$25.18	$34.72	$66.06
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.19 / $17.68	Professional	26	$6.03	$9.19	$17.68
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.00 / $26.17 / $55.14	Professional	TC	$19.00	$26.17	$55.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $30.86 / $39.20 / $57.20	Professional		$30.86	$39.20	$57.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $7.75 / $9.35 / $14.12	Professional	26	$7.75	$9.35	$14.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.92 / $30.39 / $43.82	Professional	TC	$23.92	$30.39	$43.82
United Facility/Professional Professional Modifier Low / Median / High Price $21.62 / $32.11 / $62.10	Professional		$21.62	$32.11	$62.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.03 / $9.16 / $16.01	Professional	26	$6.03	$9.16	$16.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.37 / $24.40 / $53.87	Professional	TC	$16.37	$24.40	$53.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.71 / $36.29 / $47.25	Professional		$23.71	$36.29	$47.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.54 / $8.27 / $11.28	Professional	26	$5.54	$8.27	$11.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.17 / $28.14 / $35.97	Professional	TC	$18.17	$28.14	$35.97