Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.28 / $54.98 / $80.17	Facility	26	$40.28	$54.98	$80.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.52 / $221.75 / $701.52	Professional		$118.52	$221.75	$701.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $52.10 / $158.26	Professional	26	$41.81	$52.10	$158.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.23 / $148.63 / $314.14	Professional	TC	$78.23	$148.63	$314.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $184.54 / $226.58 / $287.76	Professional		$184.54	$226.58	$287.76
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.90 / $51.90 / $65.91	Professional	26	$51.90	$51.90	$65.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $123.31 / $174.68 / $221.84	Professional	TC	$123.31	$174.68	$221.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $253.10 / $414.56	Professional		$115.33	$253.10	$414.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.52 / $58.72 / $110.62	Professional	26	$36.52	$58.72	$110.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $77.06 / $177.78 / $305.97	Professional	TC	$77.06	$177.78	$305.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $136.22 / $175.74 / $295.77	Professional		$136.22	$175.74	$295.77
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $56.69 / $97.59	Professional	26	$46.61	$56.69	$97.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $88.99 / $114.80 / $220.56	Professional	TC	$88.99	$114.80	$220.56
United Facility/Professional Professional Modifier Low / Median / High Price $125.17 / $186.92 / $336.73	Professional		$125.17	$186.92	$336.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.05 / $51.25 / $95.01	Professional	26	$29.05	$51.25	$95.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.31 / $130.07 / $255.98	Professional	TC	$91.31	$130.07	$255.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $108.98 / $147.88 / $192.26	Professional		$108.98	$147.88	$192.26
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $49.58 / $64.45	Professional	26	$37.79	$49.58	$64.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.19 / $98.31 / $125.69	Professional	TC	$71.19	$98.31	$125.69