Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.93 / $51.94 / $71.17	Facility	26	$51.93	$51.94	$71.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $275.00 / $971.41	Professional		$159.47	$275.00	$971.41
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $64.76 / $279.51	Professional	26	$51.94	$64.76	$279.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.53 / $194.00 / $447.34	Professional	TC	$107.53	$194.00	$447.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $222.60 / $232.64 / $306.35	Professional		$222.60	$232.64	$306.35
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $66.39 / $87.23	Professional	26	$61.05	$66.39	$87.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $152.11 / $166.26 / $245.31	Professional	TC	$152.11	$166.26	$245.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.58 / $287.72 / $485.64	Professional		$154.58	$287.72	$485.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $71.67 / $136.58	Professional	26	$46.78	$71.67	$136.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $105.63 / $201.37 / $371.49	Professional	TC	$105.63	$201.37	$371.49
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $182.33 / $235.21 / $395.94	Professional		$182.33	$235.21	$395.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.61 / $72.58 / $107.00	Professional	26	$59.61	$72.58	$107.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $121.84 / $157.16 / $295.37	Professional	TC	$121.84	$157.16	$295.37
United Facility/Professional Professional Modifier Low / Median / High Price $147.44 / $228.93 / $445.19	Professional		$147.44	$228.93	$445.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.34 / $62.44 / $111.88	Professional	26	$28.34	$62.44	$111.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.64 / $167.96 / $368.38	Professional	TC	$107.64	$167.96	$368.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $145.86 / $197.97 / $257.36	Professional		$145.86	$197.97	$257.36
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.38 / $63.42 / $82.45	Professional	26	$48.38	$63.42	$82.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $97.47 / $134.55 / $172.01	Professional	TC	$97.47	$134.55	$172.01