Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $11.21 / $13.56 / $13.71	Facility	26	$11.21	$13.56	$13.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.09 / $111.00 / $354.62	Professional		$75.09	$111.00	$354.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $11.21 / $12.84 / $41.50	Professional	26	$11.21	$12.84	$41.50
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.93 / $41.96 / $229.68	Professional	52	$38.93	$41.96	$229.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $66.66 / $104.06 / $215.20	Professional	TC	$66.66	$104.06	$215.20
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $95.34 / $105.93 / $121.23	Professional		$95.34	$105.93	$121.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $11.01 / $12.23 / $13.82	Professional	26	$11.01	$12.23	$13.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $84.34 / $93.71 / $108.97	Professional	TC	$84.34	$93.71	$108.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $120.41 / $185.92	Professional		$79.41	$120.41	$185.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $10.83 / $15.94 / $26.43	Professional	26	$10.83	$15.94	$26.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.36 / $107.87 / $160.94	Professional	TC	$68.36	$107.87	$160.94
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $110.08 / $155.88	Professional		$85.33	$110.08	$155.88
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $15.19 / $24.14	Professional	26	$11.96	$15.19	$24.14
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $73.38 / $94.66 / $134.69	Professional	TC	$73.38	$94.66	$134.69
United Facility/Professional Professional Modifier Low / Median / High Price $75.62 / $109.17 / $185.47	Professional		$75.62	$109.17	$185.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.93 / $13.61 / $26.23	Professional	26	$9.93	$13.61	$26.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $64.55 / $97.62 / $192.67	Professional	TC	$64.55	$97.62	$192.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $85.33 / $98.13 / $121.33	Professional		$85.33	$98.13	$121.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $11.96 / $13.75 / $17.14	Professional	26	$11.96	$13.75	$17.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $73.38 / $84.39 / $105.24	Professional	TC	$73.38	$84.39	$105.24