Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.01 / $29.44 / $43.79	Facility	26	$22.01	$29.44	$43.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.81 / $123.47 / $443.92	Professional		$82.81	$123.47	$443.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.71 / $27.68 / $72.67	Professional	26	$22.71	$27.68	$72.67
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $59.92 / $95.55 / $182.37	Professional	TC	$59.92	$95.55	$182.37
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $100.90 / $157.16 / $177.85	Professional		$100.90	$157.16	$177.85
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.08 / $29.80 / $37.85	Professional	26	$27.08	$29.80	$37.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $73.06 / $127.37 / $144.12	Professional	TC	$73.06	$127.37	$144.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.68 / $131.19 / $274.30	Professional		$81.68	$131.19	$274.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.63 / $29.87 / $58.30	Professional	26	$19.63	$29.87	$58.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.82 / $107.96 / $222.32	Professional	TC	$60.82	$107.96	$222.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $145.57 / $236.48	Professional		$108.60	$145.57	$236.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.25 / $30.38 / $44.69	Professional	26	$25.25	$30.38	$44.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $78.20 / $117.40 / $194.29	Professional	TC	$78.20	$117.40	$194.29
United Facility/Professional Professional Modifier Low / Median / High Price $71.61 / $125.74 / $231.51	Professional		$71.61	$125.74	$231.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.20 / $27.07 / $45.69	Professional	26	$20.20	$27.07	$45.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.95 / $101.90 / $178.53	Professional	TC	$51.95	$101.90	$178.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $101.26 / $138.38 / $179.75	Professional		$101.26	$138.38	$179.75
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $20.30 / $26.99 / $36.81	Professional	26	$20.30	$26.99	$36.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $80.95 / $111.81 / $142.94	Professional	TC	$80.95	$111.81	$142.94