Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.01 / $37.22 / $44.19	Facility	26	$31.01	$37.22	$44.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.04 / $91.69 / $404.36	Professional		$74.04	$91.69	$404.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.33 / $46.85 / $127.00	Professional	26	$31.33	$46.85	$127.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $43.03 / $55.88 / $155.34	Professional	TC	$43.03	$55.88	$155.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $87.42 / $97.13 / $124.33	Professional		$87.42	$97.13	$124.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.53 / $41.70 / $53.38	Professional	26	$37.53	$41.70	$53.38
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $49.89 / $55.43 / $73.17	Professional	TC	$49.89	$55.43	$73.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $106.98 / $195.03	Professional		$68.28	$106.98	$195.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.86 / $44.10 / $83.25	Professional	26	$27.86	$44.10	$83.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $40.22 / $63.86 / $123.74	Professional	TC	$40.22	$63.86	$123.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $88.47 / $110.59 / $153.72	Professional		$88.47	$110.59	$153.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.35 / $45.45 / $76.52	Professional	26	$36.35	$45.45	$76.52
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $52.11 / $66.04 / $106.19	Professional	TC	$52.11	$66.04	$106.19
United Facility/Professional Professional Modifier Low / Median / High Price $72.28 / $90.62 / $152.51	Professional		$72.28	$90.62	$152.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.19 / $39.31 / $69.54	Professional	26	$29.19	$39.31	$69.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $43.06 / $56.61 / $91.13	Professional	TC	$43.06	$56.61	$91.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $78.34 / $101.74 / $126.47	Professional		$78.34	$101.74	$126.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $32.20 / $41.81 / $53.05	Professional	26	$32.20	$41.81	$53.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $46.15 / $59.93 / $74.66	Professional	TC	$46.15	$59.93	$74.66