Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.67 / $53.70 / $60.26	Facility	26	$44.67	$53.70	$60.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $245.47 / $724.44	Professional		$134.90	$245.47	$724.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $77.62 / $190.55	Professional	26	$48.98	$77.62	$190.55
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.18 / $141.25 / $338.84	Professional	TC	$83.18	$141.25	$338.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $169.82 / $218.78	Professional		$60.26	$169.82	$218.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $85.11	Professional	26	$53.70	$67.61	$85.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $123.03 / $169.82	Professional	TC	$109.65	$123.03	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $416.87	Professional		$114.82	$223.87	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $60.26 / $114.82	Professional	26	$39.81	$60.26	$114.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $147.91 / $295.12	Professional	TC	$74.13	$147.91	$295.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $288.40	Professional		$138.04	$158.49	$288.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $56.23 / $77.62	Professional	26	$50.12	$56.23	$77.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $102.33 / $204.17	Professional	TC	$87.10	$102.33	$204.17
United Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $354.81	Professional		$120.23	$190.55	$354.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $54.95 / $97.72	Professional	26	$30.90	$54.95	$97.72
United Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $120.23 / $251.19	Professional	TC	$81.28	$120.23	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $218.78	Professional		$138.04	$162.18	$218.78
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $58.88 / $77.62	Professional	26	$51.29	$58.88	$77.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $102.33 / $141.25	Professional	TC	$87.10	$102.33	$141.25