Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $57.54	Facility	26	$40.74	$48.98	$57.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $239.88 / $588.84	Professional		$120.23	$239.88	$588.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $97.72 / $204.17	Professional	26	$42.66	$97.72	$204.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $114.82 / $338.84	Professional	TC	$74.13	$114.82	$338.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $134.90 / $190.55	Professional		$50.12	$134.90	$190.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $44.67 / $120.23	Professional	26	$44.67	$44.67	$120.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $100.00 / $114.82	Professional	TC	$89.13	$100.00	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $77.62 / $77.62 / $77.62	Facility	26	$77.62	$77.62	$77.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $162.18 / $295.12	Professional		$109.65	$162.18	$295.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $56.23 / $102.33	Professional	26	$36.31	$56.23	$102.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $107.15 / $208.93	Professional	TC	$70.79	$107.15	$208.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $165.96 / $257.04	Professional		$144.54	$165.96	$257.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $56.23 / $97.72	Professional	26	$47.86	$56.23	$97.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $109.65 / $190.55	Professional	TC	$91.20	$109.65	$190.55
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $144.54 / $263.03	Professional		$109.65	$144.54	$263.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $50.12 / $91.20	Professional	26	$38.02	$50.12	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $72.44 / $95.50 / $173.78	Professional	TC	$72.44	$95.50	$173.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $208.93	Professional		$114.82	$177.83	$208.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $58.88 / $70.79	Professional	26	$38.90	$58.88	$70.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $120.23 / $141.25	Professional	TC	$74.13	$120.23	$141.25