Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.52 / $71.06 / $104.51	Facility	26	$52.52	$71.06	$104.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $156.47 / $259.58 / $750.62	Professional		$156.47	$259.58	$750.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.45 / $73.02 / $189.26	Professional	26	$54.45	$73.02	$189.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.97 / $177.61 / $548.80	Professional	TC	$93.97	$177.61	$548.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $225.84 / $268.57 / $488.04	Professional		$225.84	$268.57	$488.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.15 / $69.84 / $118.43	Professional	26	$67.15	$69.84	$118.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $146.63 / $201.42 / $294.07	Professional	TC	$146.63	$201.42	$294.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $141.15 / $272.73 / $488.93	Professional		$141.15	$272.73	$488.93
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.31 / $71.16 / $141.50	Professional	26	$47.31	$71.16	$141.50
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $99.29 / $202.68 / $361.16	Professional	TC	$99.29	$202.68	$361.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $166.96 / $215.38 / $361.92	Professional		$166.96	$215.38	$361.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.30 / $73.22 / $107.58	Professional	26	$60.30	$73.22	$107.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $105.80 / $136.47 / $233.62	Professional	TC	$105.80	$136.47	$233.62
United Facility/Professional Professional Modifier Low / Median / High Price $143.13 / $240.72 / $433.10	Professional		$143.13	$240.72	$433.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.04 / $65.40 / $106.97	Professional	26	$32.04	$65.40	$106.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $110.58 / $168.79 / $377.00	Professional	TC	$110.58	$168.79	$377.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $133.57 / $180.96 / $235.25	Professional		$133.57	$180.96	$235.25
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.93 / $64.15 / $83.40	Professional	26	$48.93	$64.15	$83.40
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $84.64 / $116.81 / $149.33	Professional	TC	$84.64	$116.81	$149.33