Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.20 / $186.21 / $478.63	Facility		$91.20	$186.21	$478.63
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.24 / $8.71 / $10.00	Facility	26	$7.24	$8.71	$10.00
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $34.67 / $173.78 / $436.52	Facility	TC	$34.67	$173.78	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $8.91 / $40.74 / $138.04	Professional		$8.91	$40.74	$138.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $16.98 / $43.65	Professional	26	$7.94	$16.98	$43.65
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $19.95 / $83.18 / $204.17	Professional	50	$19.95	$83.18	$204.17
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.51 / $29.51 / $29.51	Professional	52	$29.51	$29.51	$29.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $44.67 / $104.71	Professional	TC	$23.44	$44.67	$104.71
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $37.15 / $46.77	Professional		$25.12	$37.15	$46.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $7.94 / $8.91 / $10.96	Professional	26	$7.94	$8.91	$10.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $32.36 / $38.02	Professional	TC	$27.54	$32.36	$38.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.48 / $35.48 / $56.23	Facility		$35.48	$35.48	$56.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $13.49 / $13.49 / $13.49	Facility	26	$13.49	$13.49	$13.49
Cigna Facility/Professional Facility Modifier TC Low / Median / High Price $43.65 / $43.65 / $43.65	Facility	TC	$43.65	$43.65	$43.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $36.31 / $75.86	Professional		$26.92	$36.31	$75.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.55 / $19.05	Professional	26	$6.61	$9.55	$19.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $27.54 / $63.10	Professional	TC	$19.95	$27.54	$63.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $43.65 / $58.88	Professional		$38.02	$43.65	$58.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.51 / $9.55 / $13.18	Professional	26	$8.51	$9.55	$13.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $33.88 / $46.77	Professional	TC	$28.84	$33.88	$46.77
United Facility/Professional Facility Modifier Low / Median / High Price $6.31 / $17.38 / $31.62	Facility		$6.31	$17.38	$31.62
United Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $35.48 / $61.66	Professional		$25.12	$35.48	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.61 / $9.12 / $15.49	Professional	26	$6.61	$9.12	$15.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $26.30 / $46.77	Professional	TC	$18.20	$26.30	$46.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $45.71 / $60.26	Professional		$25.12	$45.71	$60.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.62 / $10.00 / $12.88	Professional	26	$5.62	$10.00	$12.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $19.50 / $35.48 / $47.86	Professional	TC	$19.50	$35.48	$47.86