Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.15 / $52.97 / $59.68	Facility	26	$44.15	$52.97	$59.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $130.46 / $158.85 / $364.32	Professional		$130.46	$158.85	$364.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.76 / $57.95 / $147.22	Professional	26	$45.76	$57.95	$147.22
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $82.49 / $97.45 / $220.00	Professional	TC	$82.49	$97.45	$220.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $195.50 / $249.78 / $282.64	Professional		$195.50	$249.78	$282.64
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.48 / $79.93 / $90.45	Professional	26	$66.48	$79.93	$90.45
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $129.01 / $169.85 / $192.20	Professional	TC	$129.01	$169.85	$192.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.41 / $200.35 / $380.00	Professional		$119.41	$200.35	$380.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.72 / $60.86 / $118.86	Professional	26	$39.72	$60.86	$118.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.70 / $129.19 / $249.14	Professional	TC	$77.70	$129.19	$249.14
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $144.33 / $169.32 / $256.80	Professional		$144.33	$169.32	$256.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.62 / $59.24 / $84.08	Professional	26	$50.62	$59.24	$84.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $92.64 / $111.16 / $172.72	Professional	TC	$92.64	$111.16	$172.72
United Facility/Professional Professional Modifier Low / Median / High Price $93.22 / $153.77 / $277.88	Professional		$93.22	$153.77	$277.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.71 / $51.63 / $88.91	Professional	26	$26.71	$51.63	$88.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.70 / $106.57 / $184.73	Professional	TC	$56.70	$106.57	$184.73
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $156.78 / $203.81	Professional		$115.68	$156.78	$203.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.08 / $53.85 / $70.01	Professional	26	$41.08	$53.85	$70.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.59 / $102.93 / $131.58	Professional	TC	$74.59	$102.93	$131.58