Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	26	$22.39	$22.39	$22.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $128.82 / $524.81	Professional		$87.10	$128.82	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.90 / $107.15	Professional	26	$22.91	$38.90	$107.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $85.11 / $269.15	Professional	TC	$61.66	$85.11	$269.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $107.15 / $120.23	Professional		$85.11	$107.15	$120.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $27.54 / $30.90	Professional	26	$24.55	$27.54	$30.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $79.43 / $93.33 / $120.23	Professional	TC	$79.43	$93.33	$120.23
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	26	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $117.49 / $223.87	Professional		$79.43	$117.49	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.95 / $30.90 / $57.54	Professional	26	$19.95	$30.90	$57.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $85.11 / $173.78	Professional	TC	$57.54	$85.11	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $128.82 / $169.82	Professional		$112.20	$128.82	$169.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $30.90 / $43.65	Professional	26	$26.30	$30.90	$43.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $100.00 / $128.82	Professional	TC	$85.11	$100.00	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $114.82 / $199.53	Professional		$81.28	$114.82	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.38 / $28.18 / $50.12	Professional	26	$21.38	$28.18	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $85.11 / $154.88	Professional	TC	$58.88	$85.11	$154.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $141.25 / $165.96	Professional		$81.28	$141.25	$165.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $32.36 / $38.90	Professional	26	$19.50	$32.36	$38.90
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $63.10 / $109.65 / $128.82	Professional	TC	$63.10	$109.65	$128.82