Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.69 / $28.42 / $31.79	Facility	26	$23.69	$28.42	$31.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.44 / $87.92 / $256.08	Professional		$53.44	$87.92	$256.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.46 / $28.70 / $121.14	Professional	26	$23.46	$28.70	$121.14
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $25.01 / $34.51 / $427.24	Professional	52	$25.01	$34.51	$427.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.32 / $55.88 / $167.61	Professional	TC	$26.32	$55.88	$167.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $75.78 / $95.52	Professional		$68.20	$75.78	$95.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.69 / $28.54 / $32.63	Professional	26	$25.69	$28.54	$32.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $42.52 / $47.24 / $66.98	Professional	TC	$42.52	$47.24	$66.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.31 / $85.99 / $155.78	Professional		$46.31	$85.99	$155.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.85 / $30.11 / $57.56	Professional	26	$20.85	$30.11	$57.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.14 / $56.46 / $104.19	Professional	TC	$25.14	$56.46	$104.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $59.86 / $77.22 / $140.75	Professional		$59.86	$77.22	$140.75
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.20 / $32.92 / $46.46	Professional	26	$27.20	$32.92	$46.46
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $41.93 / $93.85	Professional	TC	$32.50	$41.93	$93.85
United Facility/Professional Professional Modifier Low / Median / High Price $64.38 / $89.47 / $170.83	Professional		$64.38	$89.47	$170.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.95 / $29.68 / $62.65	Professional	26	$20.95	$29.68	$62.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.93 / $55.80 / $94.48	Professional	TC	$41.93	$55.80	$94.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $59.86 / $68.84 / $85.57	Professional		$59.86	$68.84	$85.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.36 / $31.46 / $39.75	Professional	26	$27.36	$31.46	$39.75
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.50 / $37.38 / $46.61	Professional	TC	$32.50	$37.38	$46.61