Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $24.31 / $24.31 / $24.31	Facility	26	$24.31	$24.31	$24.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.86 / $88.01 / $164.39	Professional		$79.86	$88.01	$164.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $55.55 / $61.22 / $113.87	Professional	TC	$55.55	$61.22	$113.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $100.08 / $111.20 / $141.22	Professional		$100.08	$111.20	$141.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $69.43 / $77.15 / $97.98	Professional	TC	$69.43	$77.15	$97.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $110.45 / $201.47	Professional		$71.45	$110.45	$201.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.32 / $80.05 / $142.88	Professional	TC	$49.32	$80.05	$142.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $91.34 / $114.50 / $164.48	Professional		$91.34	$114.50	$164.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $33.28 / $49.38	Professional	26	$27.61	$33.28	$49.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $80.68 / $117.20	Professional	TC	$63.61	$80.68	$117.20
United Facility/Professional Professional Modifier Low / Median / High Price $79.40 / $110.50 / $174.64	Professional		$79.40	$110.50	$174.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.97 / $81.37 / $133.27	Professional	TC	$50.97	$81.37	$133.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $73.06 / $99.22 / $129.93	Professional		$73.06	$99.22	$129.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.89 / $70.16 / $89.67	Professional	TC	$50.89	$70.16	$89.67