Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.86 / $196.34 / $473.30	Facility		$90.86	$196.34	$473.30
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.23 / $9.81 / $14.38	Facility	26	$7.23	$9.81	$14.38
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $33.10 / $183.75 / $420.50	Facility	TC	$33.10	$183.75	$420.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.20 / $39.72 / $156.00	Professional		$11.20	$39.72	$156.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.33 / $11.54 / $40.00	Professional	26	$7.33	$11.54	$40.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.87 / $81.36 / $112.99	Professional	50	$21.87	$81.36	$112.99
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.15 / $17.91 / $43.67	Professional	52	$15.15	$17.91	$43.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.95 / $31.11 / $121.00	Professional	TC	$21.95	$31.11	$121.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.22 / $38.40 / $48.78	Professional		$33.22	$38.40	$48.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.38 / $9.31 / $12.14	Professional	26	$8.38	$9.31	$12.14
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $24.85 / $29.10 / $36.42	Professional	TC	$24.85	$29.10	$36.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.61 / $35.61 / $35.61	Facility		$35.61	$35.61	$35.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.38 / $38.04 / $75.84	Professional		$28.38	$38.04	$75.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.96 / $19.23	Professional	26	$6.55	$9.96	$19.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.82 / $28.78 / $63.32	Professional	TC	$21.82	$28.78	$63.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $44.57 / $64.51	Professional		$35.08	$44.57	$64.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.44 / $9.74 / $14.70	Professional	26	$8.44	$9.74	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.52 / $34.00 / $50.61	Professional	TC	$27.52	$34.00	$50.61
United Facility/Professional Facility Modifier Low / Median / High Price $7.62 / $20.65 / $52.74	Facility		$7.62	$20.65	$52.74
United Facility/Professional Professional Modifier Low / Median / High Price $24.96 / $35.36 / $62.37	Professional		$24.96	$35.36	$62.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.55 / $9.02 / $15.30	Professional	26	$6.55	$9.02	$15.30
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.32 / $26.35 / $49.13	Professional	TC	$18.32	$26.35	$49.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.11 / $41.27 / $53.66	Professional		$25.11	$41.27	$53.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $9.00 / $12.27	Professional	26	$5.62	$9.00	$12.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.48 / $32.38 / $41.39	Professional	TC	$19.48	$32.38	$41.39