Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $88.80 / $183.21 / $378.44	Facility		$88.80	$183.21	$378.44
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $6.92 / $9.41 / $13.79	Facility	26	$6.92	$9.41	$13.79
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $30.74 / $163.92 / $561.20	Facility	TC	$30.74	$163.92	$561.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.98 / $41.00 / $135.10	Professional		$17.98	$41.00	$135.10
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.18 / $11.07 / $40.86	Professional	26	$7.18	$11.07	$40.86
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $21.18 / $77.64 / $307.37	Professional	50	$21.18	$77.64	$307.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.20 / $16.59 / $43.67	Professional	52	$14.20	$16.59	$43.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.33 / $28.59 / $112.00	Professional	TC	$21.33	$28.59	$112.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $31.53 / $35.95 / $45.66	Professional		$31.53	$35.95	$45.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $8.01 / $8.90 / $12.00	Professional	26	$8.01	$8.90	$12.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.52 / $27.05 / $33.52	Professional	TC	$23.52	$27.05	$33.52
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 $26.70 / $35.72 / $70.95	Professional		$26.70	$35.72	$70.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.27 / $9.65 / $18.73	Professional	26	$6.27	$9.65	$18.73
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $20.18 / $27.14 / $58.86	Professional	TC	$20.18	$27.14	$58.86
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $41.66 / $60.19	Professional		$34.29	$41.66	$60.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.08 / $9.74 / $14.70	Professional	26	$8.08	$9.74	$14.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $25.56 / $32.47 / $46.90	Professional	TC	$25.56	$32.47	$46.90
United Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $33.20 / $58.51	Professional		$24.65	$33.20	$58.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $6.47 / $8.66 / $14.82	Professional	26	$6.47	$8.66	$14.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $24.54 / $43.69	Professional	TC	$18.05	$24.54	$43.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.84 / $38.57 / $50.21	Professional		$23.84	$38.57	$50.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $5.47 / $8.64 / $11.77	Professional	26	$5.47	$8.64	$11.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.36 / $30.07 / $38.43	Professional	TC	$18.36	$30.07	$38.43