Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.94 / $99.38 / $99.38	Facility	26	$49.94	$99.38	$99.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $155.97 / $275.00 / $953.76	Professional		$155.97	$275.00	$953.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.74 / $61.64 / $268.42	Professional	26	$51.74	$61.64	$268.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $106.04 / $186.91 / $450.78	Professional	TC	$106.04	$186.91	$450.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $242.36 / $282.80 / $320.01	Professional		$242.36	$282.80	$320.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.58 / $63.79 / $75.25	Professional	26	$58.58	$63.79	$75.25
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $167.11 / $219.01 / $247.83	Professional	TC	$167.11	$219.01	$247.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.47 / $308.72 / $492.24	Professional		$151.47	$308.72	$492.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.97 / $67.91 / $134.47	Professional	26	$44.97	$67.91	$134.47
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.44 / $227.52 / $382.62	Professional	TC	$104.44	$227.52	$382.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $178.93 / $230.82 / $388.68	Professional		$178.93	$230.82	$388.68
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $57.28 / $69.77 / $102.30	Professional	26	$57.28	$69.77	$102.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.80 / $155.83 / $299.42	Professional	TC	$120.80	$155.83	$299.42
United Facility/Professional Professional Modifier Low / Median / High Price $146.30 / $230.69 / $485.63	Professional		$146.30	$230.69	$485.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.66 / $62.44 / $114.06	Professional	26	$30.66	$62.44	$114.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $117.53 / $178.75 / $371.28	Professional	TC	$117.53	$178.75	$371.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $143.13 / $194.34 / $252.64	Professional		$143.13	$194.34	$252.64
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $60.94 / $79.22	Professional	26	$46.51	$60.94	$79.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $96.64 / $133.38 / $170.52	Professional	TC	$96.64	$133.38	$170.52