Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $283.20 / $283.20 / $283.20	Facility		$283.20	$283.20	$283.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $59.02 / $196.49	Professional		$44.39	$59.02	$196.49
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.07 / $18.29 / $74.50	Professional	26	$17.07	$18.29	$74.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $26.83 / $40.72 / $126.44	Professional	TC	$26.83	$40.72	$126.44
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $65.20 / $72.80 / $95.66	Professional		$65.20	$72.80	$95.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.81 / $25.05 / $36.57	Professional	26	$23.81	$25.05	$36.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $34.67 / $47.75 / $61.12	Professional	TC	$34.67	$47.75	$61.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.82 / $38.85 / $117.17	Professional		$29.82	$38.85	$117.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.25 / $12.40 / $37.58	Professional	26	$0.25	$12.40	$37.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.56 / $25.34 / $79.59	Professional	TC	$0.56	$25.34	$79.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.55 / $86.93 / $108.92	Professional		$72.55	$86.93	$108.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.91 / $26.29 / $48.20	Professional	26	$21.91	$26.29	$48.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.64 / $60.77 / $76.80	Professional	TC	$50.64	$60.77	$76.80
United Facility/Professional Professional Modifier Low / Median / High Price $43.51 / $52.54 / $105.06	Professional		$43.51	$52.54	$105.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.56 / $18.77 / $37.11	Professional	26	$15.56	$18.77	$37.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $29.09 / $36.34 / $94.20	Professional	TC	$29.09	$36.34	$94.20
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $57.12 / $90.88 / $103.40	Professional		$57.12	$90.88	$103.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.12 / $26.60 / $31.94	Professional	26	$21.12	$26.60	$31.94
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.00 / $64.29 / $72.67	Professional	TC	$36.00	$64.29	$72.67