Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $20.14 / $27.49 / $28.64	Facility	26	$20.14	$27.49	$28.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.88 / $82.29 / $284.64	Professional		$42.88	$82.29	$284.64
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.92 / $26.21 / $81.33	Professional	26	$16.92	$26.21	$81.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $22.74 / $56.82 / $139.03	Professional	TC	$22.74	$56.82	$139.03
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $51.60 / $57.33 / $96.00	Professional		$51.60	$57.33	$96.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.43 / $27.78 / $35.28	Professional	26	$20.43	$27.78	$35.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $26.59 / $29.54 / $77.17	Professional	TC	$26.59	$29.54	$77.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.49 / $68.17 / $135.07	Professional		$39.49	$68.17	$135.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.30 / $25.16 / $51.19	Professional	26	$16.30	$25.16	$51.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $21.32 / $38.29 / $93.03	Professional	TC	$21.32	$38.29	$93.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.59 / $66.55 / $97.77	Professional		$51.59	$66.55	$97.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.30 / $28.51 / $39.14	Professional	26	$23.30	$28.51	$39.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $27.97 / $35.52 / $58.46	Professional	TC	$27.97	$35.52	$58.46
United Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $68.80 / $128.40	Professional		$42.50	$68.80	$128.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.18 / $22.22 / $43.61	Professional	26	$15.18	$22.22	$43.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.24 / $38.20 / $92.27	Professional	TC	$21.24	$38.20	$92.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.50 / $59.33 / $73.79	Professional		$47.50	$59.33	$73.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.75 / $27.16 / $34.36	Professional	26	$21.75	$27.16	$34.36
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.75 / $32.17 / $40.09	Professional	TC	$25.75	$32.17	$40.09