Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.08 / $24.08 / $29.13	Facility	26	$24.08	$24.08	$29.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.66 / $121.14 / $289.82	Professional		$100.66	$121.14	$289.82
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.08 / $25.85 / $71.86	Professional	26	$24.08	$25.85	$71.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.30 / $93.52 / $217.51	Professional	TC	$74.30	$93.52	$217.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $116.69 / $140.87 / $178.90	Professional		$116.69	$140.87	$178.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.91 / $31.01 / $39.38	Professional	26	$27.91	$31.01	$39.38
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.68 / $109.86 / $139.52	Professional	TC	$85.68	$109.86	$139.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.68 / $133.60 / $289.74	Professional		$95.68	$133.60	$289.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.83 / $32.60 / $61.27	Professional	26	$21.83	$32.60	$61.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.94 / $105.09 / $225.29	Professional	TC	$70.94	$105.09	$225.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $119.13 / $153.15 / $235.90	Professional		$119.13	$153.15	$235.90
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.13 / $32.46 / $47.05	Professional	26	$28.13	$32.46	$47.05
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.72 / $121.17 / $178.21	Professional	TC	$86.72	$121.17	$178.21
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $121.25 / $221.87	Professional		$85.11	$121.25	$221.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $30.32 / $54.06	Professional	26	$20.95	$30.32	$54.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $60.22 / $92.73 / $175.31	Professional	TC	$60.22	$92.73	$175.31
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $80.95 / $141.81 / $184.16	Professional		$80.95	$141.81	$184.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.61 / $29.87 / $40.72	Professional	26	$17.61	$29.87	$40.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $63.35 / $112.19 / $143.43	Professional	TC	$63.35	$112.19	$143.43