Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.74 / $48.98 / $56.23	Facility	26	$40.74	$48.98	$56.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $257.04 / $870.96	Professional		$131.83	$257.04	$870.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $66.07 / $177.83	Professional	26	$42.66	$66.07	$177.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $389.05	Professional	TC	$83.18	$141.25	$389.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $165.96 / $234.42	Professional		$54.95	$165.96	$234.42
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $61.66 / $77.62	Professional	26	$51.29	$61.66	$77.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $123.03 / $141.25	Professional	TC	$109.65	$123.03	$141.25
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $75.86 / $75.86	Facility	26	$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $234.42 / $416.87	Professional		$112.20	$234.42	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $60.26 / $104.71	Professional	26	$36.31	$60.26	$104.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $158.49 / $309.03	Professional	TC	$74.13	$158.49	$309.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $288.40	Professional		$134.90	$158.49	$288.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $53.70 / $72.44	Professional	26	$46.77	$53.70	$72.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $102.33 / $208.93	Professional	TC	$89.13	$102.33	$208.93
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $199.53 / $363.08	Professional		$125.89	$199.53	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $52.48 / $91.20	Professional	26	$33.11	$52.48	$91.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $91.20 / $141.25 / $275.42	Professional	TC	$91.20	$141.25	$275.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $218.78	Professional		$134.90	$158.49	$218.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $54.95 / $70.79	Professional	26	$46.77	$54.95	$70.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $89.13 / $102.33 / $144.54	Professional	TC	$89.13	$102.33	$144.54