Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.86 / $39.43 / $44.75	Facility	26	$32.86	$39.43	$44.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.26 / $143.44 / $566.40	Professional		$104.26	$143.44	$566.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.86 / $42.04 / $100.06	Professional	26	$32.86	$42.04	$100.06
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $94.39 / $245.76	Professional	TC	$78.23	$94.39	$245.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $143.44 / $143.44 / $174.55	Professional		$143.44	$143.44	$174.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.93 / $42.55 / $48.64	Professional	26	$40.93	$42.55	$48.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $100.89 / $100.89 / $124.61	Professional	TC	$100.89	$100.89	$124.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.85 / $153.81 / $292.41	Professional		$100.85	$153.81	$292.41
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.76 / $45.60 / $89.14	Professional	26	$29.76	$45.60	$89.14
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $71.05 / $112.04 / $206.70	Professional	TC	$71.05	$112.04	$206.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $129.90 / $155.96 / $224.68	Professional		$129.90	$155.96	$224.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $44.43 / $63.06	Professional	26	$37.97	$44.43	$63.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $91.25 / $110.23 / $161.62	Professional	TC	$91.25	$110.23	$161.62
United Facility/Professional Professional Modifier Low / Median / High Price $110.80 / $140.41 / $230.58	Professional		$110.80	$140.41	$230.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.40 / $44.20 / $71.69	Professional	26	$30.40	$44.20	$71.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.50 / $103.61 / $168.03	Professional	TC	$79.50	$103.61	$168.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $104.31 / $141.78 / $185.57	Professional		$104.31	$141.78	$185.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.82 / $41.03 / $55.95	Professional	26	$30.82	$41.03	$55.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $73.48 / $101.39 / $129.60	Professional	TC	$73.48	$101.39	$129.60