Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	26	$39.81	$39.81	$39.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $120.23 / $354.81	Professional		$79.43	$120.23	$354.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $51.29 / $186.21	Professional	26	$18.20	$51.29	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $66.07 / $309.03	Professional	TC	$43.65	$66.07	$309.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $95.50 / $123.03	Professional		$43.65	$95.50	$123.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $47.86 / $53.70	Professional	26	$40.74	$47.86	$53.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $52.48 / $85.11	Professional	TC	$51.29	$52.48	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	26	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $120.23 / $524.81	Professional		$75.86	$120.23	$524.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.49 / $34.67 / $93.33	Professional	26	$15.49	$34.67	$93.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $83.18 / $501.19	Professional	TC	$40.74	$83.18	$501.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $112.20 / $186.21	Professional		$100.00	$112.20	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $48.98 / $67.61	Professional	26	$33.88	$48.98	$67.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $63.10 / $138.04	Professional	TC	$53.70	$63.10	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $147.91 / $416.87	Professional		$95.50	$147.91	$416.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $41.69 / $81.28	Professional	26	$14.45	$41.69	$81.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $87.10 / $389.05	Professional	TC	$52.48	$87.10	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $154.88	Professional		$85.11	$114.82	$154.88
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $53.70 / $69.18	Professional	26	$39.81	$53.70	$69.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $45.71 / $63.10 / $87.10	Professional	TC	$45.71	$63.10	$87.10