Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $30.87 / $41.64 / $43.86	Facility	26	$30.87	$41.64	$43.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.07 / $121.42 / $446.00	Professional		$84.07	$121.42	$446.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.87 / $52.08 / $126.38	Professional	26	$30.87	$52.08	$126.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $51.38 / $64.33 / $174.93	Professional	TC	$51.38	$64.33	$174.93
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $96.34 / $107.04 / $141.08	Professional		$96.34	$107.04	$141.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.15 / $40.17 / $58.65	Professional	26	$36.15	$40.17	$58.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $60.19 / $66.88 / $84.94	Professional	TC	$60.19	$66.88	$84.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.31 / $114.97 / $208.69	Professional		$73.31	$114.97	$208.69
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.61 / $43.26 / $80.22	Professional	26	$27.61	$43.26	$80.22
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.64 / $73.94 / $132.19	Professional	TC	$45.64	$73.94	$132.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $94.78 / $116.57 / $199.66	Professional		$94.78	$116.57	$199.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.69 / $43.21 / $74.52	Professional	26	$35.69	$43.21	$74.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $59.00 / $74.16 / $125.14	Professional	TC	$59.00	$74.16	$125.14
United Facility/Professional Professional Modifier Low / Median / High Price $79.27 / $100.02 / $178.01	Professional		$79.27	$100.02	$178.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.29 / $38.22 / $70.44	Professional	26	$28.29	$38.22	$70.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.35 / $63.06 / $109.85	Professional	TC	$48.35	$63.06	$109.85
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.03 / $109.00 / $135.33	Professional		$78.03	$109.00	$135.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.46 / $41.15 / $52.05	Professional	26	$29.46	$41.15	$52.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $48.57 / $67.84 / $84.70	Professional	TC	$48.57	$67.84	$84.70