Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.61 / $39.61 / $39.61	Facility	26	$39.61	$39.61	$39.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.63 / $122.02 / $361.74	Professional		$85.63	$122.02	$361.74
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $40.79 / $98.73	Professional	26	$15.71	$40.79	$98.73
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.01 / $84.68 / $329.91	Professional	TC	$46.01	$84.68	$329.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.65 / $127.89 / $564.97	Professional		$112.65	$127.89	$564.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.75 / $54.72 / $61.92	Professional	26	$19.75	$54.72	$61.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $72.84 / $73.17 / $545.22	Professional	TC	$72.84	$73.17	$545.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $76.41 / $127.80 / $474.40	Professional		$76.41	$127.80	$474.40
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.11 / $35.61 / $99.90	Professional	26	$17.11	$35.61	$99.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.78 / $85.22 / $320.20	Professional	TC	$40.78	$85.22	$320.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $98.78 / $127.43 / $189.63	Professional		$98.78	$127.43	$189.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $31.17 / $51.81 / $69.08	Professional	26	$31.17	$51.81	$69.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.73 / $68.02 / $153.24	Professional	TC	$52.73	$68.02	$153.24
United Facility/Professional Professional Modifier Low / Median / High Price $94.70 / $149.38 / $312.83	Professional		$94.70	$149.38	$312.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.34 / $43.78 / $85.47	Professional	26	$14.34	$43.78	$85.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.54 / $85.90 / $297.33	Professional	TC	$52.54	$85.90	$297.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $79.02 / $106.19 / $141.12	Professional		$79.02	$106.19	$141.12
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.84 / $48.92 / $66.70	Professional	26	$36.84	$48.92	$66.70
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $42.18 / $58.21 / $74.41	Professional	TC	$42.18	$58.21	$74.41