Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.82 / $275.68 / $423.11	Facility		$41.82	$275.68	$423.11
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.95 / $25.95 / $25.95	Facility	26	$25.95	$25.95	$25.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $82.23 / $225.55	Professional		$44.67	$82.23	$225.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.95 / $45.34 / $124.36	Professional	26	$25.95	$45.34	$124.36
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $82.23 / $179.00 / $522.88	Professional	50	$82.23	$179.00	$522.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.87 / $36.89 / $86.39	Professional	TC	$15.87	$36.89	$86.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.00 / $62.22 / $125.51	Professional		$56.00	$62.22	$125.51
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.18 / $35.76 / $52.21	Professional	26	$32.18	$35.76	$52.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.81 / $26.46 / $76.27	Professional	TC	$23.81	$26.46	$76.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.61 / $115.61 / $115.61	Facility		$115.61	$115.61	$115.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $82.56 / $154.75	Professional		$38.06	$82.56	$154.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.52 / $41.24 / $85.32	Professional	26	$23.52	$41.24	$85.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $14.59 / $34.40 / $78.04	Professional	TC	$14.59	$34.40	$78.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $63.16 / $110.97	Professional		$48.96	$63.16	$110.97
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $38.70 / $64.50	Professional	26	$30.41	$38.70	$64.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $23.94 / $44.48	Professional	TC	$18.55	$23.94	$44.48
United Facility/Professional Professional Modifier Low / Median / High Price $46.11 / $81.89 / $152.77	Professional		$46.11	$81.89	$152.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $39.46 / $63.24	Professional	26	$27.08	$39.46	$63.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.03 / $35.51 / $63.06	Professional	TC	$19.03	$35.51	$63.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $56.30 / $70.34	Professional		$48.96	$56.30	$70.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.41 / $34.97 / $44.24	Professional	26	$30.41	$34.97	$44.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.55 / $21.34 / $26.56	Professional	TC	$18.55	$21.34	$26.56