Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.97 / $52.27 / $56.95	Facility	26	$48.97	$52.27	$56.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $114.45 / $393.00	Professional		$84.00	$114.45	$393.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.81 / $48.21 / $111.70	Professional	26	$40.81	$48.21	$111.70
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $40.04 / $52.02 / $95.09	Professional	TC	$40.04	$52.02	$95.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $80.03 / $98.02 / $122.52	Professional		$80.03	$98.02	$122.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.40 / $41.56 / $51.95	Professional	26	$37.40	$41.56	$51.95
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.47 / $56.46 / $70.58	Professional	TC	$38.47	$56.46	$70.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.05 / $117.07 / $205.81	Professional		$82.05	$117.07	$205.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.72 / $61.88 / $114.06	Professional	26	$38.72	$61.88	$114.06
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $44.20 / $66.06 / $145.08	Professional	TC	$44.20	$66.06	$145.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $72.19 / $105.88 / $144.38	Professional		$72.19	$105.88	$144.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.74 / $49.49 / $67.48	Professional	26	$33.74	$49.49	$67.48
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $38.45 / $56.68 / $76.89	Professional	TC	$38.45	$56.68	$76.89
United Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $106.76 / $187.30	Professional		$74.15	$106.76	$187.30
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $55.19 / $88.31	Professional	26	$36.72	$55.19	$88.31
United Facility/Professional Professional Modifier TC Low / Median / High Price $36.95 / $51.84 / $99.84	Professional	TC	$36.95	$51.84	$99.84
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $72.05 / $110.24 / $137.81	Professional		$72.05	$110.24	$137.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $33.68 / $51.74 / $65.34	Professional	26	$33.68	$51.74	$65.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.36 / $57.97 / $72.47	Professional	TC	$38.36	$57.97	$72.47