Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.68 / $25.68 / $62.76	Facility	26	$25.68	$25.68	$62.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.16 / $76.76 / $181.96	Professional		$59.16	$76.76	$181.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $28.10 / $74.61	Professional	26	$25.68	$28.10	$74.61
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $29.44 / $31.93 / $43.63	Professional	52	$29.44	$31.93	$43.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.97 / $43.74 / $89.72	Professional	TC	$31.97	$43.74	$89.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $80.91 / $89.90 / $101.73	Professional		$80.91	$89.90	$101.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.24 / $34.71 / $39.67	Professional	26	$31.24	$34.71	$39.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $49.68 / $55.19 / $69.64	Professional	TC	$49.68	$55.19	$69.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.24 / $86.91 / $161.54	Professional		$54.24	$86.91	$161.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.82 / $34.02 / $66.06	Professional	26	$22.82	$34.02	$66.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $50.59 / $104.22	Professional	TC	$30.90	$50.59	$104.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $70.27 / $89.24 / $136.43	Professional		$70.27	$89.24	$136.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.44 / $37.19 / $49.66	Professional	26	$30.44	$37.19	$49.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $39.83 / $51.38 / $77.93	Professional	TC	$39.83	$51.38	$77.93
United Facility/Professional Professional Modifier Low / Median / High Price $58.18 / $74.19 / $123.77	Professional		$58.18	$74.19	$123.77
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.56 / $30.16 / $54.80	Professional	26	$21.56	$30.16	$54.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $31.61 / $44.34 / $79.06	Professional	TC	$31.61	$44.34	$79.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.17 / $80.81 / $100.41	Professional		$67.17	$80.81	$100.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $35.01 / $44.24	Professional	26	$29.10	$35.01	$44.24
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.07 / $45.80 / $57.14	Professional	TC	$38.07	$45.80	$57.14