Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $21.88 / $26.92 / $30.20	Facility	26	$21.88	$26.92	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $144.54 / $446.68	Professional		$95.50	$144.54	$446.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $91.20	Professional	26	$22.91	$36.31	$91.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $104.71 / $218.78	Professional	TC	$69.18	$104.71	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $26.30 / $125.89 / $158.49	Professional		$26.30	$125.89	$158.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $23.99 / $38.02	Professional	26	$23.44	$23.99	$38.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $100.00 / $112.20 / $128.82	Professional	TC	$100.00	$112.20	$128.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $40.74 / $40.74	Facility	26	$40.74	$40.74	$40.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $125.89 / $245.47	Professional		$79.43	$125.89	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $29.51 / $56.23	Professional	26	$19.50	$29.51	$56.23
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $100.00 / $223.87	Professional	TC	$56.23	$100.00	$223.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $194.98	Professional		$117.49	$141.25	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $28.18 / $38.90	Professional	26	$25.12	$28.18	$38.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $112.20 / $158.49	Professional	TC	$87.10	$112.20	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $125.89 / $229.09	Professional		$72.44	$125.89	$229.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $26.92 / $45.71	Professional	26	$20.42	$26.92	$45.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $95.50 / $177.83	Professional	TC	$51.29	$95.50	$177.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $147.91 / $204.17	Professional		$102.33	$147.91	$204.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.42 / $29.51 / $38.90	Professional	26	$20.42	$29.51	$38.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $117.49 / $162.18	Professional	TC	$81.28	$117.49	$162.18