Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.87 / $33.38 / $49.49	Facility	26	$24.87	$33.38	$49.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $96.11 / $495.00	Professional		$81.68	$96.11	$495.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.66 / $29.54 / $98.76	Professional	26	$20.66	$29.54	$98.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.40 / $70.11 / $172.02	Professional	TC	$61.40	$70.11	$172.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $90.09 / $102.12 / $126.14	Professional		$90.09	$102.12	$126.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.10 / $26.13 / $33.19	Professional	26	$24.10	$26.13	$33.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $68.39 / $75.98 / $91.95	Professional	TC	$68.39	$75.98	$91.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $102.06 / $219.74	Professional		$74.45	$102.06	$219.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.61 / $31.23 / $63.05	Professional	26	$20.61	$31.23	$63.05
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.21 / $76.18 / $154.71	Professional	TC	$54.21	$76.18	$154.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.41 / $114.54 / $177.25	Professional		$97.41	$114.54	$177.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.61 / $33.04 / $47.70	Professional	26	$25.61	$33.04	$47.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.86 / $82.17 / $129.54	Professional	TC	$70.86	$82.17	$129.54
United Facility/Professional Professional Modifier Low / Median / High Price $63.50 / $97.80 / $171.75	Professional		$63.50	$97.80	$171.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.71 / $27.04 / $51.81	Professional	26	$17.71	$27.04	$51.81
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.44 / $73.58 / $157.28	Professional	TC	$48.44	$73.58	$157.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.23 / $108.39 / $141.78	Professional		$70.23	$108.39	$141.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.27 / $30.60 / $41.73	Professional	26	$20.27	$30.60	$41.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $49.97 / $78.26 / $100.05	Professional	TC	$49.97	$78.26	$100.05