Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.00 / $20.43 / $31.52	Facility	26	$19.00	$20.43	$31.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.48 / $68.22 / $233.45	Professional		$50.48	$68.22	$233.45
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $16.27 / $20.51 / $72.00	Professional	26	$16.27	$20.51	$72.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $31.43 / $45.65 / $179.97	Professional	TC	$31.43	$45.65	$179.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $51.85 / $54.24 / $95.75	Professional		$51.85	$54.24	$95.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.70 / $19.66 / $28.70	Professional	26	$17.70	$19.66	$28.70
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $32.19 / $34.58 / $74.73	Professional	TC	$32.19	$34.58	$74.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $78.69 / $140.19	Professional		$49.01	$78.69	$140.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.03 / $24.66 / $46.12	Professional	26	$17.03	$24.66	$46.12
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $34.33 / $53.10 / $100.15	Professional	TC	$34.33	$53.10	$100.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $51.74 / $66.73 / $110.70	Professional		$51.74	$66.73	$110.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $22.21 / $35.64	Professional	26	$17.48	$22.21	$35.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $34.25 / $44.18 / $75.06	Professional	TC	$34.25	$44.18	$75.06
United Facility/Professional Professional Modifier Low / Median / High Price $49.56 / $76.86 / $120.23	Professional		$49.56	$76.86	$120.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $15.02 / $20.88 / $37.29	Professional	26	$15.02	$20.88	$37.29
United Facility/Professional Professional Modifier TC Low / Median / High Price $32.54 / $48.78 / $81.40	Professional	TC	$32.54	$48.78	$81.40
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $51.74 / $59.50 / $73.83	Professional		$51.74	$59.50	$73.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $17.48 / $20.11 / $25.55	Professional	26	$17.48	$20.11	$25.55
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $34.25 / $39.39 / $49.11	Professional	TC	$34.25	$39.39	$49.11