Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.88 / $44.77 / $65.43	Facility	26	$32.88	$44.77	$65.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.04 / $119.93 / $615.00	Professional		$101.04	$119.93	$615.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.76 / $40.25 / $153.68	Professional	26	$31.76	$40.25	$153.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.14 / $85.57 / $200.30	Professional	TC	$71.14	$85.57	$200.30
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $100.01 / $126.72 / $144.84	Professional		$100.01	$126.72	$144.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.50 / $36.36 / $41.57	Professional	26	$34.50	$36.36	$41.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $63.24 / $90.35 / $102.24	Professional	TC	$63.24	$90.35	$102.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.20 / $131.75 / $277.19	Professional		$95.20	$131.75	$277.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.95 / $42.28 / $83.52	Professional	26	$28.95	$42.28	$83.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $65.08 / $94.38 / $189.63	Professional	TC	$65.08	$94.38	$189.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $120.49 / $146.91 / $219.22	Professional		$120.49	$146.91	$219.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.13 / $44.33 / $62.55	Professional	26	$36.13	$44.33	$62.55
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $84.36 / $100.39 / $156.69	Professional	TC	$84.36	$100.39	$156.69
United Facility/Professional Professional Modifier Low / Median / High Price $86.08 / $122.34 / $205.93	Professional		$86.08	$122.34	$205.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $40.47 / $71.08	Professional	26	$26.74	$40.47	$71.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.85 / $80.84 / $137.77	Professional	TC	$56.85	$80.84	$137.77
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.51 / $136.04 / $178.19	Professional		$89.51	$136.04	$178.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.59 / $41.04 / $55.97	Professional	26	$27.59	$41.04	$55.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.92 / $95.61 / $122.23	Professional	TC	$61.92	$95.61	$122.23