Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.13 / $49.13 / $49.13	Facility	26	$49.13	$49.13	$49.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.47 / $61.78 / $113.19	Professional		$52.47	$61.78	$113.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.69 / $28.30 / $66.16	Professional	26	$24.69	$28.30	$66.16
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $27.81 / $34.52 / $67.86	Professional	TC	$27.81	$34.52	$67.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $64.23 / $95.70	Professional		$64.23	$64.23	$95.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.80 / $28.80 / $42.91	Professional	26	$28.80	$28.80	$42.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $35.43 / $35.43 / $52.79	Professional	TC	$35.43	$35.43	$52.79
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.36 / $31.36 / $31.36	Facility	26	$31.36	$31.36	$31.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.22 / $76.31 / $158.82	Professional		$58.22	$76.31	$158.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.24 / $33.82 / $59.47	Professional	26	$25.24	$33.82	$59.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $31.19 / $42.23 / $83.85	Professional	TC	$31.19	$42.23	$83.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $57.58 / $74.14 / $105.92	Professional		$57.58	$74.14	$105.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $24.00 / $30.03 / $45.01	Professional	26	$24.00	$30.03	$45.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.61 / $42.95 / $61.09	Professional	TC	$33.61	$42.95	$61.09
United Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $64.73 / $107.96	Professional		$48.22	$64.73	$107.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $22.41 / $29.26 / $47.89	Professional	26	$22.41	$29.26	$47.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $25.35 / $35.08 / $59.89	Professional	TC	$25.35	$35.08	$59.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $47.46 / $52.45 / $93.47	Professional		$47.46	$52.45	$93.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.78 / $22.36 / $39.77	Professional	26	$19.78	$22.36	$39.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $27.68 / $30.09 / $53.69	Professional	TC	$27.68	$30.09	$53.69