Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $56.23 / $72.44	Facility		$53.70	$56.23	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $44.67 / $141.25	Professional		$23.99	$44.67	$141.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $5.01 / $17.78 / $43.65	Professional	26	$5.01	$17.78	$43.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $16.22 / $28.84 / $66.07	Professional	TC	$16.22	$28.84	$66.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $6.46 / $30.90 / $38.02	Professional		$6.46	$30.90	$38.02
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $5.75 / $7.41 / $22.91	Professional	26	$5.75	$7.41	$22.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $13.80 / $25.12 / $31.62	Professional	TC	$13.80	$25.12	$31.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $0.38 / $19.95 / $64.57	Professional		$0.38	$19.95	$64.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.08 / $3.80 / $11.22	Professional	26	$0.08	$3.80	$11.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.31 / $15.85 / $46.77	Professional	TC	$0.31	$15.85	$46.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $41.69 / $60.26	Professional		$34.67	$41.69	$60.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $6.92 / $8.71 / $14.79	Professional	26	$6.92	$8.71	$14.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $33.88 / $51.29	Professional	TC	$28.18	$33.88	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.88 / $61.66	Professional		$22.39	$33.88	$61.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $4.27 / $5.75 / $11.75	Professional	26	$4.27	$5.75	$11.75
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.78 / $26.30 / $51.29	Professional	TC	$17.78	$26.30	$51.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $48.98 / $54.95	Professional		$30.90	$48.98	$54.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $6.76 / $9.55 / $10.72	Professional	26	$6.76	$9.55	$10.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $23.99 / $38.90 / $43.65	Professional	TC	$23.99	$38.90	$43.65