Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.82 / $38.82 / $43.84	Facility	26	$38.82	$38.82	$43.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $100.51 / $152.11	Professional		$65.04	$100.51	$152.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.58 / $34.82 / $83.24	Professional	26	$29.58	$34.82	$83.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.00 / $67.50 / $93.76	Professional	TC	$34.00	$67.50	$93.76
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $67.08 / $105.97 / $126.10	Professional		$67.08	$105.97	$126.10
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.22 / $31.35 / $39.22	Professional	26	$28.22	$31.35	$39.22
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.15 / $74.62 / $88.80	Professional	TC	$38.15	$74.62	$88.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.86 / $112.67 / $223.68	Professional		$62.86	$112.67	$223.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.31 / $47.16 / $86.80	Professional	26	$30.31	$47.16	$86.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $37.36 / $76.75 / $193.74	Professional	TC	$37.36	$76.75	$193.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $75.52 / $115.59 / $157.62	Professional		$75.52	$115.59	$157.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $25.67 / $37.64 / $51.33	Professional	26	$25.67	$37.64	$51.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $50.87 / $78.26 / $106.29	Professional	TC	$50.87	$78.26	$106.29
United Facility/Professional Professional Modifier Low / Median / High Price $48.22 / $92.63 / $183.89	Professional		$48.22	$92.63	$183.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.71 / $37.19 / $66.20	Professional	26	$25.71	$37.19	$66.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $17.97 / $58.89 / $145.56	Professional	TC	$17.97	$58.89	$145.56
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $65.04 / $119.72 / $149.66	Professional		$65.04	$119.72	$149.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.18 / $39.35 / $49.61	Professional	26	$21.18	$39.35	$49.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $43.86 / $80.04 / $100.05	Professional	TC	$43.86	$80.04	$100.05