Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.17 / $37.20 / $84.38	Facility		$36.17	$37.20	$84.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $101.20 / $273.38	Professional		$60.70	$101.20	$273.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.47 / $25.90 / $151.96	Professional	26	$16.47	$25.90	$151.96
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $44.23 / $71.90 / $188.69	Professional	TC	$44.23	$71.90	$188.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $59.81 / $100.04 / $161.72	Professional		$59.81	$100.04	$161.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.22 / $29.13 / $50.11	Professional	26	$26.22	$29.13	$50.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.41 / $70.91 / $90.06	Professional	TC	$27.41	$70.91	$90.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.67 / $58.08 / $158.86	Professional		$37.67	$58.08	$158.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.28 / $14.45 / $42.52	Professional	26	$0.28	$14.45	$42.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.99 / $43.65 / $121.91	Professional	TC	$0.99	$43.65	$121.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $116.02 / $139.22 / $183.83	Professional		$116.02	$139.22	$183.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.91 / $31.42 / $45.27	Professional	26	$25.91	$31.42	$45.27
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $90.11 / $108.13 / $144.22	Professional	TC	$90.11	$108.13	$144.22
United Facility/Professional Professional Modifier Low / Median / High Price $69.16 / $84.73 / $219.49	Professional		$69.16	$84.73	$219.49
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.17 / $22.02 / $50.02	Professional	26	$17.17	$22.02	$50.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.76 / $63.52 / $142.91	Professional	TC	$48.76	$63.52	$142.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $87.78 / $145.80 / $164.97	Professional		$87.78	$145.80	$164.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.10 / $31.42 / $37.83	Professional	26	$23.10	$31.42	$37.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $64.69 / $114.38 / $129.30	Professional	TC	$64.69	$114.38	$129.30