Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.55 / $19.55 / $19.55	Facility	26	$19.55	$19.55	$19.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.01 / $137.79 / $319.70	Professional		$117.01	$137.79	$319.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.48 / $117.50 / $254.68	Professional	TC	$95.48	$117.50	$254.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $110.84 / $148.44 / $169.67	Professional		$110.84	$148.44	$169.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $84.50 / $122.86 / $139.03	Professional	TC	$84.50	$122.86	$139.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $138.90 / $285.14	Professional		$100.62	$138.90	$285.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.91 / $115.80 / $265.57	Professional	TC	$81.91	$115.80	$265.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.82 / $166.54 / $249.11	Professional		$134.82	$166.54	$249.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.23 / $27.95 / $41.16	Professional	26	$23.23	$27.95	$41.16
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $108.60 / $140.87 / $206.27	Professional	TC	$108.60	$140.87	$206.27
United Facility/Professional Professional Modifier Low / Median / High Price $92.20 / $127.84 / $240.46	Professional		$92.20	$127.84	$240.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $73.06 / $107.77 / $214.83	Professional	TC	$73.06	$107.77	$214.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.25 / $158.61 / $205.38	Professional		$87.25	$158.61	$205.38
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $73.20 / $134.16 / $171.51	Professional	TC	$73.20	$134.16	$171.51