Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $691.83 / $794.33	Facility		$79.43	$691.83	$794.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $436.52 / $562.34 / $776.25	Facility	26	$436.52	$562.34	$776.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $81.28 / $302.00	Professional		$39.81	$81.28	$302.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $46.77 / $112.20	Professional	26	$33.11	$46.77	$112.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $25.12 / $33.88 / $151.36	Professional	TC	$25.12	$33.88	$151.36
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $66.07 / $125.89	Professional		$38.90	$66.07	$125.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $36.31 / $114.82	Professional	26	$36.31	$36.31	$114.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.20 / $33.88 / $39.81	Professional	TC	$30.20	$33.88	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $109.65 / $309.03	Professional		$61.66	$109.65	$309.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $60.26 / $117.49	Professional	26	$35.48	$60.26	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $46.77 / $190.55	Professional	TC	$28.18	$46.77	$190.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $75.86 / $138.04	Professional		$52.48	$75.86	$138.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $41.69 / $74.13	Professional	26	$28.84	$41.69	$74.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $23.44 / $34.67 / $64.57	Professional	TC	$23.44	$34.67	$64.57
United Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $85.11 / $141.25	Facility		$54.95	$85.11	$141.25
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $128.82 / $288.40	Professional		$61.66	$128.82	$288.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.48 / $67.61 / $104.71	Professional	26	$35.48	$67.61	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.92 / $57.54 / $181.97	Professional	TC	$26.92	$57.54	$181.97
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $102.33	Professional		$66.07	$81.28	$102.33
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $44.67 / $56.23	Professional	26	$37.15	$44.67	$56.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $28.84 / $36.31 / $45.71	Professional	TC	$28.84	$36.31	$45.71