Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.52 / $63.02 / $71.06	Facility	26	$52.52	$63.02	$71.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $143.21 / $259.14 / $721.63	Professional		$143.21	$259.14	$721.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.45 / $65.12 / $181.58	Professional	26	$54.45	$65.12	$181.58
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $84.80 / $131.69 / $313.39	Professional	TC	$84.80	$131.69	$313.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $212.52 / $237.37 / $272.98	Professional		$212.52	$237.37	$272.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.39 / $66.75 / $78.73	Professional	26	$61.39	$66.75	$78.73
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $133.79 / $170.63 / $193.07	Professional	TC	$133.79	$170.63	$193.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.83 / $254.34 / $418.39	Professional		$132.83	$254.34	$418.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.31 / $71.16 / $137.35	Professional	26	$47.31	$71.16	$137.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $83.62 / $169.56 / $286.30	Professional	TC	$83.62	$169.56	$286.30
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $157.47 / $203.15 / $338.46	Professional		$157.47	$203.15	$338.46
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 $96.31 / $124.24 / $231.35	Professional	TC	$96.31	$124.24	$231.35
United Facility/Professional Professional Modifier Low / Median / High Price $115.05 / $183.80 / $361.59	Professional		$115.05	$183.80	$361.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $32.24 / $65.95 / $121.74	Professional	26	$32.24	$65.95	$121.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $82.84 / $123.85 / $251.17	Professional	TC	$82.84	$123.85	$251.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $125.98 / $170.56 / $221.73	Professional		$125.98	$170.56	$221.73
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 $77.05 / $106.41 / $136.04	Professional	TC	$77.05	$106.41	$136.04