Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.88 / $44.62 / $52.45	Facility	26	$36.88	$44.62	$52.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.16 / $103.70 / $437.44	Professional		$49.16	$103.70	$437.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.78 / $36.88 / $156.00	Professional	26	$24.78	$36.88	$156.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $10.03 / $31.86 / $98.28	Professional	TC	$10.03	$31.86	$98.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $82.64 / $133.63	Professional		$59.15	$82.64	$133.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.82 / $35.35 / $49.32	Professional	26	$31.82	$35.35	$49.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $15.71 / $47.29 / $100.64	Professional	TC	$15.71	$47.29	$100.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.31 / $100.78 / $192.05	Professional		$42.31	$100.78	$192.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.52 / $37.27 / $84.89	Professional	26	$24.52	$37.27	$84.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $8.94 / $64.05 / $135.61	Professional	TC	$8.94	$64.05	$135.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $68.09 / $152.12	Professional		$54.48	$68.09	$152.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $38.58 / $50.27 / $64.86	Professional	26	$38.58	$50.27	$64.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $11.23 / $14.18 / $86.43	Professional	TC	$11.23	$14.18	$86.43
United Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $102.24 / $176.13	Professional		$68.16	$102.24	$176.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.98 / $32.11 / $73.36	Professional	26	$22.98	$32.11	$73.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.54 / $69.23 / $118.03	Professional	TC	$38.54	$69.23	$118.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $62.65 / $78.59	Professional		$54.48	$62.65	$78.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $43.24 / $49.73 / $62.84	Professional	26	$43.24	$49.73	$62.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $11.23 / $12.91 / $16.03	Professional	TC	$11.23	$12.91	$16.03