Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.18 / $33.88 / $38.90	Facility	26	$28.18	$33.88	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $177.83 / $524.81	Professional		$91.20	$177.83	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $51.29 / $134.90	Professional	26	$28.18	$51.29	$134.90
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $95.50 / $407.38	Professional	TC	$61.66	$95.50	$407.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $107.15 / $138.04	Professional		$30.90	$107.15	$138.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $34.67 / $47.86	Professional	26	$30.90	$34.67	$47.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $83.18 / $117.49	Professional	TC	$74.13	$83.18	$117.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	26	$52.48	$52.48	$52.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $245.47	Professional		$85.11	$125.89	$245.47
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $38.02 / $70.79	Professional	26	$25.12	$38.02	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $85.11 / $173.78	Professional	TC	$58.88	$85.11	$173.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $131.83 / $186.21	Professional		$112.20	$131.83	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.90 / $54.95	Professional	26	$33.11	$38.90	$54.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $93.33 / $128.82	Professional	TC	$74.13	$93.33	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $114.82 / $204.17	Professional		$85.11	$114.82	$204.17
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.30 / $34.67 / $63.10	Professional	26	$26.30	$34.67	$63.10
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $83.18 / $144.54	Professional	TC	$58.88	$83.18	$144.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $138.04 / $162.18	Professional		$89.13	$138.04	$162.18
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $40.74 / $48.98	Professional	26	$26.92	$40.74	$48.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $97.72 / $114.82	Professional	TC	$61.66	$97.72	$114.82