Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.32 / $39.32 / $39.32	Facility	26	$39.32	$39.32	$39.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.57 / $59.82 / $171.92	Professional		$55.57	$59.82	$171.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.99 / $41.05 / $114.22	Professional	26	$37.99	$41.05	$114.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.07 / $18.76 / $45.74	Professional	TC	$17.07	$18.76	$45.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $68.45 / $68.45 / $86.94	Professional		$68.45	$68.45	$86.94
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.37 / $46.47 / $59.02	Professional	26	$45.37	$46.47	$59.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $21.67 / $22.00 / $27.94	Professional	TC	$21.67	$22.00	$27.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $78.84 / $175.59	Professional		$52.16	$78.84	$175.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.46 / $54.96 / $122.24	Professional	26	$36.46	$54.96	$122.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $15.70 / $23.55 / $52.23	Professional	TC	$15.70	$23.55	$52.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $66.69 / $86.98 / $130.93	Professional		$66.69	$86.98	$130.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.68 / $60.81 / $89.95	Professional	26	$45.68	$60.81	$89.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $20.30 / $26.19 / $40.98	Professional	TC	$20.30	$26.19	$40.98
United Facility/Professional Professional Modifier Low / Median / High Price $49.06 / $70.84 / $114.90	Professional		$49.06	$70.84	$114.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.39 / $47.97 / $82.84	Professional	26	$32.39	$47.97	$82.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $15.30 / $19.54 / $34.09	Professional	TC	$15.30	$19.54	$34.09
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $50.40 / $77.47 / $93.76	Professional		$50.40	$77.47	$93.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.22 / $54.21 / $64.69	Professional	26	$35.22	$54.21	$64.69
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $15.18 / $22.86 / $29.07	Professional	TC	$15.18	$22.86	$29.07