Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $595.97 / $595.97 / $623.54	Facility		$595.97	$595.97	$623.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $21.09 / $30.06 / $97.28	Professional		$21.09	$30.06	$97.28
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.83 / $3.91 / $14.30	Professional	26	$2.83	$3.91	$14.30
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.98 / $12.99 / $16.41	Professional	52	$9.98	$12.99	$16.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $18.35 / $26.91 / $60.62	Professional	TC	$18.35	$26.91	$60.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $14.54 / $23.05 / $26.05	Professional		$14.54	$23.05	$26.05
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $2.04 / $2.84 / $5.59	Professional	26	$2.04	$2.84	$5.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $12.50 / $20.21 / $22.84	Professional	TC	$12.50	$20.21	$22.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.11 / $55.11 / $55.11	Facility		$55.11	$55.11	$55.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.14 / $35.20 / $64.34	Professional		$19.14	$35.20	$64.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $2.61 / $4.92 / $12.07	Professional	26	$2.61	$4.92	$12.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $17.11 / $30.09 / $54.39	Professional	TC	$17.11	$30.09	$54.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $30.13 / $45.82	Professional		$24.12	$30.13	$45.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $3.08 / $4.01 / $6.36	Professional	26	$3.08	$4.01	$6.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $21.00 / $25.80 / $39.46	Professional	TC	$21.00	$25.80	$39.46
United Facility/Professional Professional Modifier Low / Median / High Price $19.96 / $33.72 / $62.63	Professional		$19.96	$33.72	$62.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $2.81 / $4.42 / $9.72	Professional	26	$2.81	$4.42	$9.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $25.32 / $40.40	Professional	TC	$16.80	$25.32	$40.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.30 / $26.37 / $33.96	Professional		$19.30	$26.37	$33.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $2.50 / $3.24 / $4.41	Professional	26	$2.50	$3.24	$4.41
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $16.80 / $23.13 / $29.55	Professional	TC	$16.80	$23.13	$29.55