Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.71 / $32.19 / $47.18	Facility	26	$23.71	$32.19	$47.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $101.07 / $283.36	Professional		$52.12	$101.07	$283.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.71 / $29.52 / $80.09	Professional	26	$23.71	$29.52	$80.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.10 / $71.65 / $124.42	Professional	TC	$27.10	$71.65	$124.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $76.08 / $84.53 / $123.41	Professional		$76.08	$84.53	$123.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.34 / $37.79 / $52.73	Professional	26	$31.34	$37.79	$52.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $42.06 / $46.73 / $88.74	Professional	TC	$42.06	$46.73	$88.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.98 / $83.06 / $162.22	Professional		$47.98	$83.06	$162.22
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.13 / $31.95 / $60.22	Professional	26	$21.13	$31.95	$60.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $26.43 / $46.89 / $99.43	Professional	TC	$26.43	$46.89	$99.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $62.67 / $80.84 / $134.69	Professional		$62.67	$80.84	$134.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $33.51 / $49.38	Professional	26	$27.61	$33.51	$49.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.94 / $45.07 / $73.27	Professional	TC	$34.94	$45.07	$73.27
United Facility/Professional Professional Modifier Low / Median / High Price $51.57 / $81.50 / $146.94	Professional		$51.57	$81.50	$146.94
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.54 / $31.19 / $51.07	Professional	26	$22.54	$31.19	$51.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.62 / $44.45 / $101.30	Professional	TC	$26.62	$44.45	$101.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $72.06 / $89.52	Professional		$57.58	$72.06	$89.52
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $25.48 / $31.89 / $40.25	Professional	26	$25.48	$31.89	$40.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $32.10 / $40.18 / $50.12	Professional	TC	$32.10	$40.18	$50.12