Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.14 / $46.15 / $63.24	Facility	26	$46.14	$46.15	$63.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.43 / $232.72 / $824.63	Professional		$135.43	$232.72	$824.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $56.66 / $238.85	Professional	26	$47.85	$56.66	$238.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.27 / $151.13 / $362.87	Professional	TC	$89.27	$151.13	$362.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $203.45 / $226.05 / $287.08	Professional		$203.45	$226.05	$287.08
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.07 / $58.58 / $76.97	Professional	26	$54.07	$58.58	$76.97
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $141.41 / $167.47 / $217.71	Professional	TC	$141.41	$167.47	$217.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.85 / $251.08 / $414.35	Professional		$131.85	$251.08	$414.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.53 / $62.80 / $124.33	Professional	26	$41.53	$62.80	$124.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $88.38 / $179.58 / $306.29	Professional	TC	$88.38	$179.58	$306.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $156.01 / $201.25 / $338.44	Professional		$156.01	$201.25	$338.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $64.22 / $95.25	Professional	26	$52.95	$64.22	$95.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $102.32 / $131.99 / $239.87	Professional	TC	$102.32	$131.99	$239.87
United Facility/Professional Professional Modifier Low / Median / High Price $132.52 / $195.37 / $368.12	Professional		$132.52	$195.37	$368.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $57.74 / $94.23	Professional	26	$33.21	$57.74	$94.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $92.25 / $140.28 / $298.83	Professional	TC	$92.25	$140.28	$298.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $124.81 / $169.29 / $220.08	Professional		$124.81	$169.29	$220.08
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.96 / $56.33 / $73.23	Professional	26	$42.96	$56.33	$73.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $81.86 / $112.96 / $144.38	Professional	TC	$81.86	$112.96	$144.38