Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.90 / $38.90 / $38.90	Facility	26	$38.90	$38.90	$38.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $83.18 / $208.93	Professional		$52.48	$83.18	$208.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $64.57 / $213.80	Professional	26	$38.02	$64.57	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $21.88 / $58.88	Professional	TC	$15.14	$21.88	$58.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $64.57 / $91.20	Professional		$44.67	$64.57	$91.20
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $51.29 / $93.33	Professional	26	$44.67	$51.29	$93.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $22.39 / $37.15	Professional	TC	$19.95	$22.39	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $77.62 / $173.78	Professional		$51.29	$77.62	$173.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $54.95 / $123.03	Professional	26	$36.31	$54.95	$123.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.85 / $23.44 / $53.70	Professional	TC	$15.85	$23.44	$53.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $75.86 / $114.82	Professional		$66.07	$75.86	$114.82
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $52.48 / $77.62	Professional	26	$45.71	$52.48	$77.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $19.95 / $22.91 / $36.31	Professional	TC	$19.95	$22.91	$36.31
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $117.49	Professional		$48.98	$66.07	$117.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $46.77 / $83.18	Professional	26	$32.36	$46.77	$83.18
United Facility/Professional Professional Modifier TC Low / Median / High Price $14.79 / $19.50 / $34.67	Professional	TC	$14.79	$19.50	$34.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $79.43 / $102.33	Professional		$50.12	$79.43	$102.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $54.95 / $69.18	Professional	26	$35.48	$54.95	$69.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.14 / $23.99 / $31.62	Professional	TC	$15.14	$23.99	$31.62