Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $26.73 / $28.66 / $31.30	Facility	26	$26.73	$28.66	$31.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $119.52 / $462.00	Professional		$98.60	$119.52	$462.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.85 / $28.83 / $109.56	Professional	26	$22.85	$28.83	$109.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $70.31 / $86.57 / $207.52	Professional	TC	$70.31	$86.57	$207.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $103.54 / $103.96 / $117.47	Professional		$103.54	$103.96	$117.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $24.35 / $27.06 / $43.06	Professional	26	$24.35	$27.06	$43.06
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $64.51 / $76.91 / $88.47	Professional	TC	$64.51	$76.91	$88.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.44 / $139.44 / $297.82	Professional		$99.44	$139.44	$297.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.09 / $34.50 / $64.80	Professional	26	$24.09	$34.50	$64.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.69 / $109.41 / $238.69	Professional	TC	$76.69	$109.41	$238.69
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $101.12 / $130.44 / $205.56	Professional		$101.12	$130.44	$205.56
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.61 / $31.25 / $50.09	Professional	26	$24.61	$31.25	$50.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $76.51 / $98.70 / $155.47	Professional	TC	$76.51	$98.70	$155.47
United Facility/Professional Professional Modifier Low / Median / High Price $83.80 / $118.94 / $207.40	Professional		$83.80	$118.94	$207.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $20.96 / $29.74 / $52.59	Professional	26	$20.96	$29.74	$52.59
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.81 / $88.81 / $172.46	Professional	TC	$64.81	$88.81	$172.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $99.71 / $116.29 / $143.76	Professional		$99.71	$116.29	$143.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.27 / $28.30 / $35.84	Professional	26	$24.27	$28.30	$35.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $75.44 / $87.99 / $109.75	Professional	TC	$75.44	$87.99	$109.75