Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.46 / $47.15 / $68.56	Facility	26	$34.46	$47.15	$68.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.43 / $121.47 / $468.00	Professional		$93.43	$121.47	$468.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.46 / $47.55 / $184.00	Professional	26	$34.46	$47.55	$184.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $56.82 / $68.79 / $167.28	Professional	TC	$56.82	$68.79	$167.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $105.64 / $117.38 / $177.45	Professional		$105.64	$117.38	$177.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $41.56 / $46.18 / $79.86	Professional	26	$41.56	$46.18	$79.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.06 / $71.19 / $99.31	Professional	TC	$64.06	$71.19	$99.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.65 / $123.64 / $247.50	Professional		$85.65	$123.64	$247.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.92 / $48.85 / $92.12	Professional	26	$30.92	$48.85	$92.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.21 / $78.38 / $156.19	Professional	TC	$52.21	$78.38	$156.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $111.96 / $134.35 / $197.80	Professional		$111.96	$134.35	$197.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.40 / $48.81 / $85.08	Professional	26	$40.40	$48.81	$85.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.02 / $86.93 / $130.77	Professional	TC	$69.02	$86.93	$130.77
United Facility/Professional Professional Modifier Low / Median / High Price $80.76 / $113.26 / $210.38	Professional		$80.76	$113.26	$210.38
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.13 / $40.98 / $77.25	Professional	26	$32.13	$40.98	$77.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $50.97 / $71.04 / $132.81	Professional	TC	$50.97	$71.04	$132.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.02 / $128.75 / $159.99	Professional		$93.02	$128.75	$159.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.56 / $46.46 / $58.95	Professional	26	$33.56	$46.46	$58.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $59.46 / $82.29 / $102.74	Professional	TC	$59.46	$82.29	$102.74