Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.14 / $62.44 / $91.83	Facility	26	$46.14	$62.44	$91.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.31 / $264.68 / $941.09	Professional		$139.31	$264.68	$941.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.85 / $65.43 / $226.85	Professional	26	$47.85	$65.43	$226.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.15 / $176.98 / $439.14	Professional	TC	$93.15	$176.98	$439.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $211.77 / $235.30 / $298.83	Professional		$211.77	$235.30	$298.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $67.87 / $86.19	Professional	26	$62.17	$67.87	$86.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $147.59 / $167.43 / $212.64	Professional	TC	$147.59	$167.43	$212.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.41 / $276.14 / $476.57	Professional		$135.41	$276.14	$476.57
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.53 / $68.30 / $130.30	Professional	26	$41.53	$68.30	$130.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $92.24 / $188.85 / $355.56	Professional	TC	$92.24	$188.85	$355.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $159.85 / $206.21 / $375.43	Professional		$159.85	$206.21	$375.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.95 / $67.62 / $109.35	Professional	26	$52.95	$67.62	$109.35
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $106.15 / $136.93 / $273.67	Professional	TC	$106.15	$136.93	$273.67
United Facility/Professional Professional Modifier Low / Median / High Price $139.60 / $201.71 / $412.22	Professional		$139.60	$201.71	$412.22
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.06 / $63.51 / $106.96	Professional	26	$37.06	$63.51	$106.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $97.86 / $136.62 / $320.19	Professional	TC	$97.86	$136.62	$320.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $127.88 / $173.53 / $225.59	Professional		$127.88	$173.53	$225.59
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 $84.92 / $117.20 / $149.82	Professional	TC	$84.92	$117.20	$149.82