Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.36 / $35.48 / $51.29	Facility	26	$32.36	$35.48	$51.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $144.54 / $512.86	Professional		$93.33	$144.54	$512.86
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $60.26 / $213.80	Professional	26	$23.99	$60.26	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $100.00 / $245.47	Professional	TC	$67.61	$100.00	$245.47
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $112.20 / $134.90	Professional		$28.18	$112.20	$134.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $30.90 / $35.48	Professional	26	$30.20	$30.90	$35.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $89.13 / $114.82	Professional	TC	$85.11	$89.13	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $72.44 / $218.78	Professional		$41.69	$72.44	$218.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.22 / $18.20 / $53.70	Professional	26	$11.22	$18.20	$53.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $53.70 / $165.96	Professional	TC	$30.20	$53.70	$165.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $162.18 / $218.78	Professional		$134.90	$162.18	$218.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $38.02 / $56.23	Professional	26	$33.11	$38.02	$56.23
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $123.03 / $162.18	Professional	TC	$102.33	$123.03	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $109.65 / $181.97	Professional		$69.18	$109.65	$181.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $25.70 / $46.77	Professional	26	$18.20	$25.70	$46.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $51.29 / $83.18 / $134.90	Professional	TC	$51.29	$83.18	$134.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $213.80	Professional		$114.82	$169.82	$213.80
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $39.81 / $50.12	Professional	26	$30.20	$39.81	$50.12
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $128.82 / $162.18	Professional	TC	$85.11	$128.82	$162.18