Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.99 / $28.84 / $32.36	Facility	26	$23.99	$28.84	$32.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $138.04 / $489.78	Professional		$72.44	$138.04	$489.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $48.98 / $97.72	Professional	26	$25.70	$48.98	$97.72
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $89.13 / $316.23	Professional	TC	$47.86	$89.13	$316.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $128.82 / $144.54	Professional		$97.72	$128.82	$144.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.62 / $35.48 / $37.15	Professional	26	$31.62	$35.48	$37.15
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $102.33 / $123.03	Professional	TC	$81.28	$102.33	$123.03
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $269.15	Professional		$81.28	$117.49	$269.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $31.62 / $67.61	Professional	26	$21.38	$31.62	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $87.10 / $190.55	Professional	TC	$60.26	$87.10	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $117.49 / $162.18	Professional		$97.72	$117.49	$162.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $30.20 / $41.69	Professional	26	$26.92	$30.20	$41.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $85.11 / $120.23	Professional	TC	$72.44	$85.11	$120.23
United Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $107.15 / $186.21	Professional		$53.70	$107.15	$186.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $29.51 / $51.29	Professional	26	$16.22	$29.51	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $37.15 / $77.62 / $138.04	Professional	TC	$37.15	$77.62	$138.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $123.03 / $165.96	Professional		$70.79	$123.03	$165.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $31.62 / $41.69	Professional	26	$18.20	$31.62	$41.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $89.13 / $123.03	Professional	TC	$51.29	$89.13	$123.03