Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.01 / $28.81 / $32.19	Facility	26	$24.01	$28.81	$32.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.52 / $99.23 / $478.00	Professional		$66.52	$99.23	$478.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.03 / $29.35 / $123.15	Professional	26	$24.03	$29.35	$123.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.13 / $74.38 / $316.00	Professional	TC	$48.13	$74.38	$316.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $106.79 / $106.79 / $143.00	Professional		$106.79	$106.79	$143.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $29.66 / $29.66 / $37.96	Professional	26	$29.66	$29.66	$37.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $77.13 / $77.13 / $107.59	Professional	TC	$77.13	$77.13	$107.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.30 / $132.16 / $279.91	Professional		$86.30	$132.16	$279.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.33 / $32.40 / $63.36	Professional	26	$21.33	$32.40	$63.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.93 / $96.07 / $207.83	Professional	TC	$61.93	$96.07	$207.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $86.96 / $124.64 / $185.44	Professional		$86.96	$124.64	$185.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.32 / $31.89 / $46.03	Professional	26	$27.32	$31.89	$46.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.13 / $93.26 / $139.41	Professional	TC	$56.13	$93.26	$139.41
United Facility/Professional Professional Modifier Low / Median / High Price $51.17 / $101.18 / $186.98	Professional		$51.17	$101.18	$186.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $11.41 / $29.59 / $51.92	Professional	26	$11.41	$29.59	$51.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.78 / $75.09 / $138.80	Professional	TC	$36.78	$75.09	$138.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.02 / $115.41 / $150.03	Professional		$70.02	$115.41	$150.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.32 / $29.06 / $37.78	Professional	26	$18.32	$29.06	$37.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $51.70 / $86.35 / $110.39	Professional	TC	$51.70	$86.35	$110.39