Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.57 / $47.12 / $68.81	Facility	26	$34.57	$47.12	$68.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.41 / $184.29 / $650.00	Professional		$100.41	$184.29	$650.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.58 / $42.89 / $117.00	Professional	26	$34.58	$42.89	$117.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $62.84 / $142.12 / $425.25	Professional	TC	$62.84	$142.12	$425.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $146.26 / $162.51 / $211.26	Professional		$146.26	$162.51	$211.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.82 / $44.12 / $57.98	Professional	26	$40.82	$44.12	$57.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $98.56 / $118.39 / $162.91	Professional	TC	$98.56	$118.39	$162.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $194.27 / $325.04	Professional		$94.12	$194.27	$325.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.32 / $48.24 / $93.08	Professional	26	$31.32	$48.24	$93.08
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.60 / $126.48 / $236.41	Professional	TC	$61.60	$126.48	$236.41
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.10 / $144.61 / $238.84	Professional		$112.10	$144.61	$238.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $48.27 / $71.73	Professional	26	$39.97	$48.27	$71.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $71.56 / $92.31 / $175.31	Professional	TC	$71.56	$92.31	$175.31
United Facility/Professional Professional Modifier Low / Median / High Price $96.64 / $152.12 / $286.51	Professional		$96.64	$152.12	$286.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $43.48 / $73.81	Professional	26	$20.27	$43.48	$73.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $63.41 / $96.82 / $242.41	Professional	TC	$63.41	$96.82	$242.41
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.68 / $121.56 / $158.03	Professional		$89.68	$121.56	$158.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.44 / $42.53 / $55.29	Professional	26	$32.44	$42.53	$55.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.25 / $79.03 / $101.04	Professional	TC	$57.25	$79.03	$101.04