Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.92 / $78.77 / $135.43	Facility		$34.92	$78.77	$135.43
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $12.25 / $12.26 / $16.79	Facility	26	$12.25	$12.26	$16.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.91 / $37.57 / $166.71	Professional		$30.91	$37.57	$166.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $12.26 / $14.37 / $52.35	Professional	26	$12.26	$14.37	$52.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.89 / $23.27 / $59.42	Professional	TC	$17.89	$23.27	$59.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.33 / $42.30 / $48.35	Professional		$33.33	$42.30	$48.35
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $14.35 / $15.94 / $18.22	Professional	26	$14.35	$15.94	$18.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.28 / $26.35 / $30.12	Professional	TC	$18.28	$26.35	$30.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $29.89 / $29.89 / $29.89	Facility		$29.89	$29.89	$29.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $39.92 / $84.88	Professional		$28.46	$39.92	$84.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $16.37 / $30.74	Professional	26	$10.47	$16.37	$30.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.00 / $24.05 / $52.06	Professional	TC	$17.00	$24.05	$52.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $39.76 / $49.70 / $69.84	Professional		$39.76	$49.70	$69.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $13.40 / $16.92 / $28.15	Professional	26	$13.40	$16.92	$28.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $26.23 / $31.80 / $44.40	Professional	TC	$26.23	$31.80	$44.40
United Facility/Professional Professional Modifier Low / Median / High Price $27.65 / $35.70 / $67.91	Professional		$27.65	$35.70	$67.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.51 / $14.22 / $25.77	Professional	26	$11.51	$14.22	$25.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.92 / $21.86 / $43.06	Professional	TC	$15.92	$21.86	$43.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $27.36 / $45.72 / $56.57	Professional		$27.36	$45.72	$56.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $9.31 / $15.56 / $19.62	Professional	26	$9.31	$15.56	$19.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $18.05 / $30.16 / $36.95	Professional	TC	$18.05	$30.16	$36.95