Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.86 / $55.86 / $71.73	Facility		$55.86	$55.86	$71.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.24 / $80.88 / $243.29	Professional		$55.24	$80.88	$243.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $73.70 / $481.76	Professional	26	$37.85	$73.70	$481.76
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $17.57 / $33.58 / $83.12	Professional	TC	$17.57	$33.58	$83.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $88.01 / $107.62 / $158.03	Professional		$88.01	$107.62	$158.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $62.20 / $69.11 / $153.71	Professional	26	$62.20	$69.11	$153.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $20.86 / $38.51 / $48.91	Professional	TC	$20.86	$38.51	$48.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $53.33 / $159.90	Professional		$37.25	$53.33	$159.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.69 / $33.28 / $96.58	Professional	26	$0.69	$33.28	$96.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.47 / $21.16 / $63.32	Professional	TC	$0.47	$21.16	$63.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $103.30 / $123.96 / $161.27	Professional		$103.30	$123.96	$161.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.68 / $73.81 / $111.25	Professional	26	$60.68	$73.81	$111.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $42.62 / $51.14 / $74.65	Professional	TC	$42.62	$51.14	$74.65
United Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $80.26 / $180.59	Professional		$59.64	$80.26	$180.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.43 / $51.88 / $97.98	Professional	26	$38.43	$51.88	$97.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $21.18 / $27.95 / $80.91	Professional	TC	$21.18	$27.95	$80.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.05 / $127.90 / $148.58	Professional		$84.05	$127.90	$148.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $54.82 / $73.81 / $88.46	Professional	26	$54.82	$73.81	$88.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.23 / $54.08 / $61.14	Professional	TC	$29.23	$54.08	$61.14