Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.11 / $39.81 / $66.07	Facility	26	$33.11	$39.81	$66.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $141.25 / $616.60	Professional		$100.00	$141.25	$616.60
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $66.07 / $125.89	Professional	26	$32.36	$66.07	$125.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $91.20 / $208.93	Professional	TC	$64.57	$91.20	$208.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $123.03 / $141.25	Professional		$40.74	$123.03	$141.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $36.31 / $46.77	Professional	26	$33.11	$36.31	$46.77
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $91.20 / $100.00	Professional	TC	$81.28	$91.20	$100.00
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $123.03 / $245.47	Professional		$93.33	$123.03	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $38.90 / $83.18	Professional	26	$27.54	$38.90	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $89.13 / $190.55	Professional	TC	$64.57	$89.13	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $141.25 / $194.98	Professional		$123.03	$141.25	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $42.66 / $58.88	Professional	26	$37.15	$42.66	$58.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $100.00 / $138.04	Professional	TC	$85.11	$100.00	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $123.03 / $213.80	Professional		$85.11	$123.03	$213.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $39.81 / $70.79	Professional	26	$26.92	$39.81	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $81.28 / $147.91	Professional	TC	$56.23	$81.28	$147.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $147.91 / $204.17	Professional		$89.13	$147.91	$204.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $44.67 / $57.54	Professional	26	$27.54	$44.67	$57.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $104.71 / $144.54	Professional	TC	$61.66	$104.71	$144.54