Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $37.15 / $44.67 / $51.29	Facility	26	$37.15	$44.67	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $112.20 / $457.09	Professional		$51.29	$112.20	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $52.48 / $154.88	Professional	26	$25.12	$52.48	$154.88
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $213.80 / $213.80	Professional	50	$138.04	$213.80	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $28.84 / $102.33	Professional	TC	$10.00	$28.84	$102.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $12.30 / $52.48 / $64.57	Professional		$12.30	$52.48	$64.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $48.98	Professional	26	$40.74	$45.71	$48.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $10.96 / $11.22 / $42.66	Professional	TC	$10.96	$11.22	$42.66
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $69.18 / $69.18 / $69.18	Facility	26	$69.18	$69.18	$69.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $109.65 / $186.21	Professional		$44.67	$109.65	$186.21
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $37.15 / $74.13	Professional	26	$23.44	$37.15	$74.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $9.33 / $69.18 / $131.83	Professional	TC	$9.33	$69.18	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $64.57 / $134.90	Professional		$56.23	$64.57	$134.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $48.98 / $63.10	Professional	26	$38.02	$48.98	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.75 / $13.80 / $93.33	Professional	TC	$11.75	$13.80	$93.33
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $104.71 / $173.78	Professional		$67.61	$104.71	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $32.36 / $61.66	Professional	26	$23.44	$32.36	$61.66
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $72.44 / $125.89	Professional	TC	$37.15	$72.44	$125.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $69.18 / $81.28	Professional		$54.95	$69.18	$81.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $53.70 / $64.57	Professional	26	$43.65	$53.70	$64.57
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.22 / $14.79 / $17.38	Professional	TC	$11.22	$14.79	$17.38