Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.74 / $48.00 / $65.15	Facility	26	$32.74	$48.00	$65.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.33 / $156.19 / $412.53	Professional		$128.33	$156.19	$412.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.74 / $48.51 / $146.11	Professional	26	$32.74	$48.51	$146.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $71.01 / $112.69 / $256.32	Professional	TC	$71.01	$112.69	$256.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $48.51 / $177.38 / $225.27	Professional		$48.51	$177.38	$225.27
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.81 / $48.39 / $61.46	Professional	26	$38.81	$48.39	$61.46
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $9.99 / $128.99 / $163.82	Professional	TC	$9.99	$128.99	$163.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $99.83 / $289.86	Professional		$56.56	$99.83	$289.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.96 / $27.52 / $91.61	Professional	26	$17.96	$27.52	$91.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.93 / $75.75 / $198.24	Professional	TC	$31.93	$75.75	$198.24
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $180.59 / $217.14 / $320.83	Professional		$180.59	$217.14	$320.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.66 / $52.75 / $80.00	Professional	26	$41.66	$52.75	$80.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $138.93 / $168.78 / $251.07	Professional	TC	$138.93	$168.78	$251.07
United Facility/Professional Professional Modifier Low / Median / High Price $95.47 / $142.58 / $276.08	Professional		$95.47	$142.58	$276.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.94 / $38.54 / $73.41	Professional	26	$28.94	$38.54	$73.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $69.98 / $107.56 / $174.62	Professional	TC	$69.98	$107.56	$174.62
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.91 / $207.68 / $257.08	Professional		$154.91	$207.68	$257.08
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.14 / $47.91 / $60.93	Professional	26	$38.14	$47.91	$60.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $116.77 / $159.77 / $199.47	Professional	TC	$116.77	$159.77	$199.47