Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.87 / $36.13 / $40.14	Facility	26	$26.87	$36.13	$40.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $102.90 / $380.00	Professional		$72.28	$102.90	$380.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.64 / $46.35 / $119.09	Professional	26	$27.64	$46.35	$119.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $45.41 / $62.21 / $173.02	Professional	TC	$45.41	$62.21	$173.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $89.32 / $99.25 / $127.04	Professional		$89.32	$99.25	$127.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.78 / $34.20 / $49.93	Professional	26	$30.78	$34.20	$49.93
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $55.76 / $65.05 / $82.61	Professional	TC	$55.76	$65.05	$82.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.64 / $101.31 / $189.74	Professional		$64.64	$101.31	$189.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.72 / $37.32 / $68.37	Professional	26	$23.72	$37.32	$68.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.65 / $65.88 / $122.50	Professional	TC	$40.65	$65.88	$122.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $83.46 / $107.66 / $174.00	Professional		$83.46	$107.66	$174.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.98 / $39.13 / $64.11	Professional	26	$30.98	$39.13	$64.11
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.38 / $67.56 / $109.98	Professional	TC	$52.38	$67.56	$109.98
United Facility/Professional Professional Modifier Low / Median / High Price $70.09 / $91.39 / $169.48	Professional		$70.09	$91.39	$169.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.30 / $31.47 / $57.31	Professional	26	$24.30	$31.47	$57.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $44.74 / $56.02 / $97.85	Professional	TC	$44.74	$56.02	$97.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $70.37 / $95.98 / $119.09	Professional		$70.37	$95.98	$119.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.21 / $35.74 / $45.17	Professional	26	$26.21	$35.74	$45.17
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $44.16 / $60.24 / $75.18	Professional	TC	$44.16	$60.24	$75.18