Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $28.84 / $33.11	Facility	26	$23.44	$28.84	$33.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $380.19	Professional		$51.29	$97.72	$380.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $44.67 / $114.82	Professional	26	$23.99	$44.67	$114.82
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $45.71 / $95.50 / $426.58	Professional	52	$45.71	$95.50	$426.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $52.48 / $190.55	Professional	TC	$25.70	$52.48	$190.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $57.54 / $75.86	Professional		$28.84	$57.54	$75.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.70 / $25.70 / $32.36	Professional	26	$25.70	$25.70	$32.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $35.48 / $45.71	Professional	TC	$32.36	$35.48	$45.71
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $44.67 / $44.67	Facility	26	$44.67	$44.67	$44.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $87.10 / $154.88	Professional		$46.77	$87.10	$154.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $30.20 / $60.26	Professional	26	$20.89	$30.20	$60.26
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $25.70 / $58.88 / $100.00	Professional	TC	$25.70	$58.88	$100.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $75.86 / $138.04	Professional		$64.57	$75.86	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $33.11 / $43.65	Professional	26	$28.18	$33.11	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $42.66 / $81.28	Professional	TC	$35.48	$42.66	$81.28
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $83.18 / $147.91	Professional		$61.66	$83.18	$147.91
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.89 / $28.18 / $51.29	Professional	26	$20.89	$28.18	$51.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $56.23 / $95.50	Professional	TC	$40.74	$56.23	$95.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $79.43 / $93.33	Professional		$60.26	$79.43	$93.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $27.54 / $34.67 / $41.69	Professional	26	$27.54	$34.67	$41.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.36 / $45.71 / $51.29	Professional	TC	$32.36	$45.71	$51.29