Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.29 / $35.33 / $37.29	Facility	26	$26.29	$35.33	$37.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.90 / $139.72 / $585.14	Professional		$89.90	$139.72	$585.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.23 / $44.28 / $136.21	Professional	26	$27.23	$44.28	$136.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $63.61 / $88.18 / $235.08	Professional	TC	$63.61	$88.18	$235.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $113.89 / $126.54 / $176.53	Professional		$113.89	$126.54	$176.53
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.18 / $35.75 / $52.20	Professional	26	$32.18	$35.75	$52.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $81.70 / $90.79 / $126.65	Professional	TC	$81.70	$90.79	$126.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.39 / $115.72 / $220.98	Professional		$71.39	$115.72	$220.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.20 / $35.02 / $66.89	Professional	26	$23.20	$35.02	$66.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $47.52 / $78.02 / $157.93	Professional	TC	$47.52	$78.02	$157.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.43 / $131.36 / $184.28	Professional		$103.43	$131.36	$184.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $30.29 / $37.03 / $54.09	Professional	26	$30.29	$37.03	$54.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.03 / $92.75 / $133.86	Professional	TC	$73.03	$92.75	$133.86
United Facility/Professional Professional Modifier Low / Median / High Price $84.09 / $113.78 / $195.87	Professional		$84.09	$113.78	$195.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $32.46 / $56.06	Professional	26	$24.61	$32.46	$56.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.53 / $81.48 / $129.25	Professional	TC	$54.53	$81.48	$129.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $118.94 / $147.16	Professional		$67.40	$118.94	$147.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.82 / $34.97 / $44.18	Professional	26	$19.82	$34.97	$44.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $47.59 / $83.98 / $104.74	Professional	TC	$47.59	$83.98	$104.74