Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $28.41 / $38.89 / $56.53	Facility	26	$28.41	$38.89	$56.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.71 / $120.00 / $729.24	Professional		$59.71	$120.00	$729.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.41 / $81.73 / $706.96	Professional	26	$28.41	$81.73	$706.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.60 / $40.02 / $118.78	Professional	TC	$29.60	$40.02	$118.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $74.65 / $74.65 / $109.19	Professional		$74.65	$74.65	$109.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.08 / $33.08 / $42.01	Professional	26	$33.08	$33.08	$42.01
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $41.57 / $41.57 / $67.63	Professional	TC	$41.57	$41.57	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.81 / $87.90 / $179.46	Professional		$53.81	$87.90	$179.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.98 / $38.92 / $86.56	Professional	26	$25.98	$38.92	$86.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $27.84 / $48.66 / $92.90	Professional	TC	$27.84	$48.66	$92.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $89.75 / $137.19	Professional		$69.56	$89.75	$137.19
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.58 / $43.32 / $64.38	Professional	26	$32.58	$43.32	$64.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.99 / $46.43 / $81.45	Professional	TC	$35.99	$46.43	$81.45
United Facility/Professional Professional Modifier Low / Median / High Price $55.20 / $72.98 / $118.36	Professional		$55.20	$72.98	$118.36
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.72 / $33.56 / $58.79	Professional	26	$22.72	$33.56	$58.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $30.09 / $41.75 / $61.01	Professional	TC	$30.09	$41.75	$61.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.26 / $79.50 / $97.70	Professional		$61.26	$79.50	$97.70
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.57 / $38.61 / $46.07	Professional	26	$29.57	$38.61	$46.07
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $31.69 / $40.61 / $51.62	Professional	TC	$31.69	$40.61	$51.62