Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.29 / $38.10 / $56.29	Facility	26	$28.29	$38.10	$56.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.99 / $129.97 / $525.00	Professional		$93.99	$129.97	$525.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.29 / $45.22 / $131.00	Professional	26	$28.29	$45.22	$131.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.70 / $94.75 / $414.00	Professional	TC	$65.70	$94.75	$414.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $124.12 / $137.91 / $204.75	Professional		$124.12	$137.91	$204.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $35.97 / $71.73	Professional	26	$32.39	$35.97	$71.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $91.74 / $101.93 / $142.19	Professional	TC	$91.74	$101.93	$142.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.98 / $127.72 / $238.04	Professional		$83.98	$127.72	$238.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.01 / $37.72 / $72.01	Professional	26	$25.01	$37.72	$72.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $58.64 / $87.59 / $173.75	Professional	TC	$58.64	$87.59	$173.75
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $108.57 / $137.88 / $192.46	Professional		$108.57	$137.88	$192.46
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.64 / $39.51 / $58.80	Professional	26	$32.64	$39.51	$58.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $75.81 / $95.76 / $138.18	Professional	TC	$75.81	$95.76	$138.18
United Facility/Professional Professional Modifier Low / Median / High Price $86.15 / $111.52 / $222.58	Professional		$86.15	$111.52	$222.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.45 / $35.01 / $67.16	Professional	26	$26.45	$35.01	$67.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.65 / $86.74 / $190.23	Professional	TC	$59.65	$86.74	$190.23
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $88.45 / $124.86 / $154.55	Professional		$88.45	$124.86	$154.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.68 / $37.65 / $47.63	Professional	26	$26.68	$37.65	$47.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.77 / $87.19 / $108.75	Professional	TC	$61.77	$87.19	$108.75