Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.05 / $71.73 / $180.48	Professional		$66.05	$71.73	$180.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.64 / $19.57 / $45.41	Professional	26	$17.64	$19.57	$45.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $48.40 / $53.32 / $77.19	Professional	TC	$48.40	$53.32	$77.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.55 / $67.55 / $91.43	Professional		$67.55	$67.55	$91.43
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.45 / $18.45 / $24.65	Professional	26	$18.45	$18.45	$24.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $49.10 / $49.10 / $66.78	Professional	TC	$49.10	$49.10	$66.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $78.65 / $101.46 / $171.60	Professional		$78.65	$101.46	$171.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.04 / $27.14 / $43.86	Professional	26	$21.04	$27.14	$43.86
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $57.61 / $74.31 / $127.22	Professional	TC	$57.61	$74.31	$127.22
United Facility/Professional Professional Modifier Low / Median / High Price $66.37 / $104.55 / $153.02	Professional		$66.37	$104.55	$153.02
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.83 / $20.93 / $47.47	Professional	26	$14.83	$20.93	$47.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $48.75 / $79.48 / $130.82	Professional	TC	$48.75	$79.48	$130.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.92 / $90.45 / $111.77	Professional		$62.92	$90.45	$111.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.82 / $24.20 / $30.45	Professional	26	$16.82	$24.20	$30.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $46.09 / $66.25 / $82.69	Professional	TC	$46.09	$66.25	$82.69