Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $44.42 / $60.08 / $88.41	Facility	26	$44.42	$60.08	$88.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.55 / $229.67 / $695.00	Professional		$126.55	$229.67	$695.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.04 / $55.03 / $195.07	Professional	26	$46.04	$55.03	$195.07
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $77.34 / $119.70 / $314.33	Professional	TC	$77.34	$119.70	$314.33
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $183.68 / $204.09 / $265.32	Professional		$183.68	$204.09	$265.32
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $52.33 / $56.34 / $74.02	Professional	26	$52.33	$56.34	$74.02
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $121.88 / $147.75 / $204.92	Professional	TC	$121.88	$147.75	$204.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.00 / $225.06 / $403.00	Professional		$118.00	$225.06	$403.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.97 / $61.25 / $119.66	Professional	26	$39.97	$61.25	$119.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $76.33 / $156.13 / $295.66	Professional	TC	$76.33	$156.13	$295.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $139.62 / $180.11 / $300.14	Professional		$139.62	$180.11	$300.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $50.94 / $61.89 / $91.71	Professional	26	$50.94	$61.89	$91.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $113.46 / $218.92	Professional	TC	$87.95	$113.46	$218.92
United Facility/Professional Professional Modifier Low / Median / High Price $118.09 / $175.31 / $348.67	Professional		$118.09	$175.31	$348.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.89 / $55.58 / $93.95	Professional	26	$25.89	$55.58	$93.95
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.67 / $117.08 / $240.90	Professional	TC	$78.67	$117.08	$240.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $111.70 / $151.35 / $196.76	Professional		$111.70	$151.35	$196.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $41.34 / $54.19 / $70.45	Professional	26	$41.34	$54.19	$70.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $70.36 / $97.16 / $124.20	Professional	TC	$70.36	$97.16	$124.20