Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $275.42 / $426.58	Facility		$41.69	$275.42	$426.58
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $25.70 / $25.70	Facility	26	$25.70	$25.70	$25.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $91.20 / $234.42	Professional		$44.67	$91.20	$234.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $50.12 / $165.96	Professional	26	$25.70	$50.12	$165.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $83.18 / $223.87 / $524.81	Professional	50	$83.18	$223.87	$524.81
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $14.13 / $23.44 / $77.62	Professional	TC	$14.13	$23.44	$77.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $35.48 / $58.88	Professional		$20.42	$35.48	$58.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $32.36 / $44.67	Professional	26	$28.84	$32.36	$44.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.20 / $18.20 / $27.54	Professional	TC	$18.20	$18.20	$27.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $114.82	Facility		$74.13	$74.13	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $87.10 / $158.49	Professional		$38.90	$87.10	$158.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $42.66 / $85.11	Professional	26	$23.44	$42.66	$85.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.45 / $36.31 / $85.11	Professional	TC	$14.45	$36.31	$85.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $58.88 / $109.65	Professional		$51.29	$58.88	$109.65
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $37.15 / $60.26	Professional	26	$31.62	$37.15	$60.26
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $23.44 / $47.86	Professional	TC	$19.95	$23.44	$47.86
United Facility/Professional Facility Modifier Low / Median / High Price $21.38 / $39.81 / $67.61	Facility		$21.38	$39.81	$67.61
United Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $81.28 / $134.90	Professional		$45.71	$81.28	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $41.69 / $69.18	Professional	26	$26.92	$41.69	$69.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $35.48 / $69.18	Professional	TC	$19.05	$35.48	$69.18
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $63.10 / $74.13	Professional		$48.98	$63.10	$74.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $38.90 / $45.71	Professional	26	$30.20	$38.90	$45.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.62 / $25.12 / $29.51	Professional	TC	$18.62	$25.12	$29.51