Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $22.39 / $27.54 / $30.20	Facility	26	$22.39	$27.54	$30.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $169.82 / $478.63	Professional		$95.50	$169.82	$478.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $38.02 / $109.65	Professional	26	$22.91	$38.02	$109.65
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $91.20 / $218.78	Professional	TC	$67.61	$91.20	$218.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $107.15 / $120.23	Professional		$38.90	$107.15	$120.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $25.70 / $29.51	Professional	26	$23.44	$25.70	$29.51
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $85.11 / $91.20	Professional	TC	$75.86	$85.11	$91.20
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.81 / $39.81 / $39.81	Facility	26	$39.81	$39.81	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $223.87	Professional		$100.00	$134.90	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.99 / $33.11 / $58.88	Professional	26	$23.99	$33.11	$58.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $102.33 / $177.83	Professional	TC	$75.86	$102.33	$177.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $204.17	Professional		$107.15	$123.03	$204.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $29.51 / $42.66	Professional	26	$25.12	$29.51	$42.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $95.50 / $154.88	Professional	TC	$81.28	$95.50	$154.88
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $117.49 / $199.53	Professional		$87.10	$117.49	$199.53
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.88 / $29.51 / $50.12	Professional	26	$21.88	$29.51	$50.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.57 / $89.13 / $154.88	Professional	TC	$64.57	$89.13	$154.88
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $134.90 / $158.49	Professional		$100.00	$134.90	$158.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.55 / $30.90 / $37.15	Professional	26	$24.55	$30.90	$37.15
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $75.86 / $104.71 / $120.23	Professional	TC	$75.86	$104.71	$120.23