Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.94 / $51.94 / $51.94	Facility	26	$51.94	$51.94	$51.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.15 / $214.97 / $792.38	Professional		$182.15	$214.97	$792.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.94 / $55.00 / $168.79	Professional	26	$51.94	$55.00	$168.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $130.21 / $152.94 / $523.86	Professional	TC	$130.21	$152.94	$523.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $283.02 / $339.83 / $384.55	Professional		$283.02	$339.83	$384.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.05 / $65.98 / $77.84	Professional	26	$61.05	$65.98	$77.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $205.20 / $273.85 / $309.89	Professional	TC	$205.20	$273.85	$309.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $176.90 / $360.30 / $587.24	Professional		$176.90	$360.30	$587.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $71.25 / $136.58	Professional	26	$46.51	$71.25	$136.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $128.25 / $274.10 / $467.36	Professional	TC	$128.25	$274.10	$467.36
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $207.08 / $267.13 / $450.70	Professional		$207.08	$267.13	$450.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.26 / $72.16 / $107.60	Professional	26	$59.26	$72.16	$107.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $146.94 / $189.57 / $370.34	Professional	TC	$146.94	$189.57	$370.34
United Facility/Professional Professional Modifier Low / Median / High Price $178.24 / $277.49 / $545.66	Professional		$178.24	$277.49	$545.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.88 / $64.59 / $119.70	Professional	26	$31.88	$64.59	$119.70
United Facility/Professional Professional Modifier TC Low / Median / High Price $143.76 / $221.07 / $469.53	Professional	TC	$143.76	$221.07	$469.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.66 / $225.35 / $292.95	Professional		$165.66	$225.35	$292.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $63.04 / $81.95	Professional	26	$48.10	$63.04	$81.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $117.56 / $162.31 / $207.50	Professional	TC	$117.56	$162.31	$207.50