Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.67 / $46.77 / $69.18	Facility	26	$34.67	$46.77	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $194.98 / $501.19	Professional		$95.50	$194.98	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $85.11 / $213.80	Professional	26	$36.31	$85.11	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $87.10 / $323.59	Professional	TC	$57.54	$87.10	$323.59
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $117.49 / $144.54	Professional		$67.61	$117.49	$144.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $42.66 / $61.66	Professional	26	$38.02	$42.66	$61.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $77.62 / $85.11	Professional	TC	$70.79	$77.62	$85.11
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.07 / $66.07 / $66.07	Facility	26	$66.07	$66.07	$66.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $120.23 / $234.42	Professional		$85.11	$120.23	$234.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $47.86 / $89.13	Professional	26	$30.90	$47.86	$89.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $75.86 / $154.88	Professional	TC	$51.29	$75.86	$154.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $194.98	Professional		$112.20	$134.90	$194.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $48.98 / $70.79	Professional	26	$41.69	$48.98	$70.79
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.79 / $87.10 / $128.82	Professional	TC	$70.79	$87.10	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $114.82 / $208.93	Professional		$79.43	$114.82	$208.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $42.66 / $77.62	Professional	26	$32.36	$42.66	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.65 / $72.44 / $131.83	Professional	TC	$43.65	$72.44	$131.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $147.91 / $173.78	Professional		$93.33	$147.91	$173.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $51.29 / $61.66	Professional	26	$33.88	$51.29	$61.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $95.50 / $112.20	Professional	TC	$58.88	$95.50	$112.20