Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $57.54 / $64.57	Facility	26	$46.77	$57.54	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $234.42 / $524.81	Professional		$114.82	$234.42	$524.81
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $95.50 / $194.98	Professional	26	$51.29	$95.50	$194.98
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $446.68	Professional	TC	$144.54	$218.78	$446.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $275.42 / $323.59	Professional		$234.42	$275.42	$323.59
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $69.18 / $77.62	Professional	26	$54.95	$69.18	$77.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $213.80 / $234.42	Professional	TC	$190.55	$213.80	$234.42
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.13 / $89.13 / $89.13	Facility	26	$89.13	$89.13	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $549.54	Professional		$177.83	$295.12	$549.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.66 / $64.57 / $117.49	Professional	26	$42.66	$64.57	$117.49
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $223.87 / $416.87	Professional	TC	$131.83	$223.87	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $239.88 / $354.81	Professional		$208.93	$239.88	$354.81
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $61.66 / $83.18	Professional	26	$53.70	$61.66	$83.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $181.97 / $288.40	Professional	TC	$154.88	$181.97	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $269.15 / $426.58	Professional		$165.96	$269.15	$426.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $58.88 / $102.33	Professional	26	$33.11	$58.88	$102.33
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $204.17 / $354.81	Professional	TC	$131.83	$204.17	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $245.47 / $331.13	Professional		$208.93	$245.47	$331.13
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $64.57 / $83.18	Professional	26	$54.95	$64.57	$83.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $181.97 / $251.19	Professional	TC	$154.88	$181.97	$251.19