Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.57 / $34.28 / $39.15	Facility	26	$28.57	$34.28	$39.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $83.01 / $329.00	Professional		$73.93	$83.01	$329.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.57 / $32.52 / $79.33	Professional	26	$28.57	$32.52	$79.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.88 / $50.03 / $121.69	Professional	TC	$43.88	$50.03	$121.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $88.16 / $97.95 / $111.96	Professional		$88.16	$97.95	$111.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.40 / $39.34 / $44.97	Professional	26	$35.40	$39.34	$44.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $52.75 / $58.61 / $66.98	Professional	TC	$52.75	$58.61	$66.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.78 / $96.66 / $186.50	Professional		$64.78	$96.66	$186.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.82 / $39.24 / $77.28	Professional	26	$25.82	$39.24	$77.28
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $39.08 / $60.67 / $110.87	Professional	TC	$39.08	$60.67	$110.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $84.03 / $100.08 / $147.32	Professional		$84.03	$100.08	$147.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.97 / $38.59 / $54.81	Professional	26	$32.97	$38.59	$54.81
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.31 / $60.77 / $92.51	Professional	TC	$50.31	$60.77	$92.51
United Facility/Professional Professional Modifier Low / Median / High Price $66.98 / $88.76 / $146.24	Professional		$66.98	$88.76	$146.24
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.76 / $35.72 / $60.32	Professional	26	$26.76	$35.72	$60.32
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.40 / $49.78 / $89.87	Professional	TC	$38.40	$49.78	$89.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.31 / $90.98 / $120.05	Professional		$67.31	$90.98	$120.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.81 / $35.63 / $48.59	Professional	26	$26.81	$35.63	$48.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $40.51 / $55.90 / $71.45	Professional	TC	$40.51	$55.90	$71.45