Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	26	$33.88	$33.88	$33.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $112.20 / $309.03	Professional		$75.86	$112.20	$309.03
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $46.77 / $70.79 / $194.98	Professional	TC	$46.77	$70.79	$194.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $128.82 / $165.96	Professional		$46.77	$128.82	$165.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $85.11 / $97.72 / $158.49	Professional	TC	$85.11	$97.72	$158.49
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	26	$64.57	$64.57	$64.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $134.90 / $275.42	Professional		$85.11	$134.90	$275.42
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.70 / $91.20 / $199.53	Professional	TC	$53.70	$91.20	$199.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $131.83 / $173.78	Professional		$114.82	$131.83	$173.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $45.71 / $63.10	Professional	26	$40.74	$45.71	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $87.10 / $114.82	Professional	TC	$74.13	$87.10	$114.82
United Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $223.87	Professional		$91.20	$134.90	$223.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.95 / $87.10 / $158.49	Professional	TC	$54.95	$87.10	$158.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $134.90 / $177.83	Professional		$91.20	$134.90	$177.83
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $87.10 / $117.49	Professional	TC	$57.54	$87.10	$117.49