Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $15.40 / $18.63 / $21.68	Facility	26	$15.40	$18.63	$21.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.93 / $116.53 / $544.44	Professional		$87.93	$116.53	$544.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.40 / $18.59 / $79.59	Professional	26	$15.40	$18.59	$79.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.22 / $87.32 / $223.08	Professional	TC	$72.22	$87.32	$223.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $118.97 / $132.19 / $167.88	Professional		$118.97	$132.19	$167.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $20.02 / $20.02 / $26.31	Professional	26	$20.02	$20.02	$26.31
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $100.95 / $112.17 / $142.46	Professional	TC	$100.95	$112.17	$142.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $104.24 / $221.42	Professional		$73.93	$104.24	$221.42
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.10 / $20.80 / $39.72	Professional	26	$14.10	$20.80	$39.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $61.63 / $90.56 / $190.12	Professional	TC	$61.63	$90.56	$190.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.13 / $127.08 / $182.33	Professional		$101.13	$127.08	$182.33
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $18.17 / $22.10 / $29.97	Professional	26	$18.17	$22.10	$29.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $82.72 / $105.05 / $152.37	Professional	TC	$82.72	$105.05	$152.37
United Facility/Professional Professional Modifier Low / Median / High Price $77.01 / $97.80 / $179.61	Professional		$77.01	$97.80	$179.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.33 / $19.13 / $36.29	Professional	26	$14.33	$19.13	$36.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $62.03 / $81.02 / $135.62	Professional	TC	$62.03	$81.02	$135.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $110.50 / $143.28	Professional		$74.34	$110.50	$143.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $13.54 / $19.39 / $26.46	Professional	26	$13.54	$19.39	$26.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $60.81 / $91.37 / $116.81	Professional	TC	$60.81	$91.37	$116.81