Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $17.38 / $17.38 / $17.38	Facility	26	$17.38	$17.38	$17.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $134.90 / $245.47	Professional		$77.62	$134.90	$245.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.98 / $32.36 / $72.44	Professional	26	$16.98	$32.36	$72.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $79.43 / $190.55	Professional	TC	$54.95	$79.43	$190.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $100.00 / $120.23	Professional		$19.05	$100.00	$120.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $22.91	Professional	26	$19.05	$21.38	$22.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $91.20 / $97.72	Professional	TC	$81.28	$91.20	$97.72
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $32.36 / $32.36	Facility	26	$32.36	$32.36	$32.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $199.53	Professional		$69.18	$100.00	$199.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $22.91 / $44.67	Professional	26	$15.49	$22.91	$44.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $75.86 / $165.96	Professional	TC	$52.48	$75.86	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $114.82 / $158.49	Professional		$104.71	$114.82	$158.49
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $22.39 / $30.90	Professional	26	$20.42	$22.39	$30.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $93.33 / $128.82	Professional	TC	$83.18	$93.33	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $173.78	Professional		$67.61	$93.33	$173.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $21.38 / $37.15	Professional	26	$15.85	$21.38	$37.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $70.79 / $131.83	Professional	TC	$52.48	$70.79	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $120.23 / $162.18	Professional		$69.18	$120.23	$162.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.80 / $23.44 / $30.90	Professional	26	$13.80	$23.44	$30.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $97.72 / $131.83	Professional	TC	$56.23	$97.72	$131.83