Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $41.69 / $47.86	Facility	26	$34.67	$41.69	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $199.53 / $691.83	Professional		$104.71	$199.53	$691.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $44.67 / $131.83	Professional	26	$36.31	$44.67	$131.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.07 / $128.82 / $416.87	Professional	TC	$66.07	$128.82	$416.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $134.90 / $173.78	Professional		$46.77	$134.90	$173.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $43.65 / $52.48 / $58.88	Professional	26	$43.65	$52.48	$58.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $89.13 / $295.12	Professional	TC	$87.10	$89.13	$295.12
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	26	$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $186.21 / $331.13	Professional		$93.33	$186.21	$331.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $89.13	Professional	26	$30.90	$46.77	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $120.23 / $239.88	Professional	TC	$58.88	$120.23	$239.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $234.42	Professional		$109.65	$128.82	$234.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $44.67 / $61.66	Professional	26	$39.81	$44.67	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $165.96	Professional	TC	$70.79	$83.18	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $151.36 / $281.84	Professional		$97.72	$151.36	$281.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $43.65 / $77.62	Professional	26	$23.99	$43.65	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $97.72 / $213.80	Professional	TC	$64.57	$97.72	$213.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $177.83	Professional		$112.20	$128.82	$177.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $46.77 / $61.66	Professional	26	$40.74	$46.77	$61.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $83.18 / $114.82	Professional	TC	$70.79	$83.18	$114.82