Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.29 / $32.29 / $44.25	Facility	26	$32.29	$32.29	$44.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.67 / $92.00 / $389.67	Professional		$66.67	$92.00	$389.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.50 / $39.78 / $168.35	Professional	26	$33.50	$39.78	$168.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.36 / $49.65 / $192.00	Professional	TC	$34.36	$49.65	$192.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $75.76 / $84.17 / $168.27	Professional		$75.76	$84.17	$168.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.86 / $41.16 / $47.05	Professional	26	$35.86	$41.16	$47.05
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.71 / $43.01 / $132.40	Professional	TC	$38.71	$43.01	$132.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $97.42 / $212.30	Professional		$63.39	$97.42	$212.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.29 / $45.48 / $87.54	Professional	26	$29.29	$45.48	$87.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $32.95 / $51.99 / $138.09	Professional	TC	$32.95	$51.99	$138.09
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $81.96 / $100.01 / $122.94	Professional		$81.96	$100.01	$122.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.32 / $45.17 / $62.02	Professional	26	$37.32	$45.17	$62.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $44.09 / $56.88 / $66.14	Professional	TC	$44.09	$56.88	$66.14
United Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $86.58 / $144.46	Professional		$59.27	$86.58	$144.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.50 / $39.22 / $69.93	Professional	26	$20.50	$39.22	$69.93
United Facility/Professional Professional Modifier TC Low / Median / High Price $27.78 / $42.77 / $103.20	Professional	TC	$27.78	$42.77	$103.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.56 / $88.27 / $117.05	Professional		$65.56	$88.27	$117.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.30 / $40.32 / $54.97	Professional	26	$30.30	$40.32	$54.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $35.27 / $48.57 / $62.07	Professional	TC	$35.27	$48.57	$62.07