Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.31 / $110.94 / $230.33	Facility		$65.31	$110.94	$230.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $7.50 / $10.21 / $14.94	Facility	26	$7.50	$10.21	$14.94
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $23.18 / $92.74 / $234.04	Facility	TC	$23.18	$92.74	$234.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.86 / $32.92 / $108.00	Professional		$24.86	$32.92	$108.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.79 / $9.55 / $35.04	Professional	26	$7.79	$9.55	$35.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.64 / $21.07 / $74.00	Professional	TC	$16.64	$21.07	$74.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.14 / $32.17 / $36.77	Professional		$30.14	$32.17	$36.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $9.23 / $10.26 / $11.72	Professional	26	$9.23	$10.26	$11.72
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.88 / $21.91 / $25.04	Professional	TC	$19.88	$21.91	$25.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.62 / $33.90 / $67.20	Professional		$23.62	$33.90	$67.20
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $6.80 / $10.42 / $20.30	Professional	26	$6.80	$10.42	$20.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $16.55 / $24.00 / $48.46	Professional	TC	$16.55	$24.00	$48.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $31.01 / $37.29 / $52.08	Professional		$31.01	$37.29	$52.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $8.68 / $10.15 / $14.43	Professional	26	$8.68	$10.15	$14.43
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $22.20 / $26.87 / $37.65	Professional	TC	$22.20	$26.87	$37.65
United Facility/Professional Professional Modifier Low / Median / High Price $22.65 / $29.46 / $53.76	Professional		$22.65	$29.46	$53.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.05 / $9.90 / $21.78	Professional	26	$7.05	$9.90	$21.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.62 / $20.21 / $36.02	Professional	TC	$15.62	$20.21	$36.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $23.87 / $33.90 / $44.30	Professional		$23.87	$33.90	$44.30
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.73 / $9.36 / $12.77	Professional	26	$6.73	$9.36	$12.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $17.14 / $24.67 / $31.53	Professional	TC	$17.14	$24.67	$31.53