Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.11 / $24.80 / $97.60	Facility		$24.11	$24.80	$97.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $74.33 / $198.34	Professional		$44.39	$74.33	$198.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.42 / $17.51 / $91.57	Professional	26	$7.42	$17.51	$91.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $36.96 / $59.13 / $166.88	Professional	TC	$36.96	$59.13	$166.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.22 / $73.41 / $93.23	Professional		$29.22	$73.41	$93.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $12.13 / $13.48 / $17.71	Professional	26	$12.13	$13.48	$17.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $17.71 / $59.93 / $76.11	Professional	TC	$17.71	$59.93	$76.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.61 / $42.20 / $110.66	Professional		$27.61	$42.20	$110.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.13 / $6.45 / $18.96	Professional	26	$0.13	$6.45	$18.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.81 / $35.92 / $107.80	Professional	TC	$0.81	$35.92	$107.80
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.48 / $102.58 / $136.00	Professional		$85.48	$102.58	$136.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.83 / $14.31 / $25.93	Professional	26	$11.83	$14.31	$25.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.65 / $88.38 / $117.96	Professional	TC	$73.65	$88.38	$117.96
United Facility/Professional Professional Modifier Low / Median / High Price $49.37 / $61.12 / $115.85	Professional		$49.37	$61.12	$115.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $7.51 / $10.08 / $22.73	Professional	26	$7.51	$10.08	$22.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $38.79 / $51.68 / $116.28	Professional	TC	$38.79	$51.68	$116.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.93 / $107.86 / $121.93	Professional		$63.93	$107.86	$121.93
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.54 / $14.31 / $17.19	Professional	26	$10.54	$14.31	$17.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $53.39 / $93.55 / $105.76	Professional	TC	$53.39	$93.55	$105.76