Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $46.77 / $56.23 / $64.57	Facility	26	$46.77	$56.23	$64.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $537.03	Professional		$100.00	$194.98	$537.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $112.20 / $245.47	Professional	26	$52.48	$112.20	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $186.21 / $426.58	Professional	TC	$114.82	$186.21	$426.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $213.80 / $263.03	Professional		$64.57	$213.80	$263.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $64.57 / $81.28	Professional	26	$50.12	$64.57	$81.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $165.96 / $190.55	Professional	TC	$147.91	$165.96	$190.55
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 $144.54 / $275.42 / $489.78	Professional		$144.54	$275.42	$489.78
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 $100.00 / $194.98 / $371.54	Professional	TC	$100.00	$194.98	$371.54
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $363.08	Professional		$169.82	$199.53	$363.08
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 $120.23 / $138.04 / $263.03	Professional	TC	$120.23	$138.04	$263.03
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $239.88 / $416.87	Professional		$158.49	$239.88	$416.87
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 $112.20 / $181.97 / $323.59	Professional	TC	$112.20	$181.97	$323.59
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $204.17 / $275.42	Professional		$173.78	$204.17	$275.42
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 $120.23 / $138.04 / $190.55	Professional	TC	$120.23	$138.04	$190.55