Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.29 / $57.23 / $94.12	Facility	26	$47.29	$57.23	$94.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.04 / $255.77 / $894.06	Professional		$153.04	$255.77	$894.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $59.86 / $277.00	Professional	26	$49.03	$59.86	$277.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.74 / $191.27 / $767.39	Professional	TC	$105.74	$191.27	$767.39
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $237.92 / $280.50 / $317.41	Professional		$237.92	$280.50	$317.41
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $55.48 / $60.83 / $71.30	Professional	26	$55.48	$60.83	$71.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $166.63 / $219.67 / $248.57	Professional	TC	$166.63	$219.67	$248.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $148.71 / $290.95 / $473.71	Professional		$148.71	$290.95	$473.71
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $65.22 / $124.11	Professional	26	$42.57	$65.22	$124.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $104.14 / $221.38 / $359.81	Professional	TC	$104.14	$221.38	$359.81
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $175.14 / $225.93 / $380.72	Professional		$175.14	$225.93	$380.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.28 / $66.04 / $97.59	Professional	26	$54.28	$66.04	$97.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.10 / $154.93 / $292.52	Professional	TC	$120.10	$154.93	$292.52
United Facility/Professional Professional Modifier Low / Median / High Price $157.35 / $216.36 / $395.19	Professional		$157.35	$216.36	$395.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.25 / $59.19 / $109.62	Professional	26	$29.25	$59.19	$109.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.89 / $167.91 / $354.82	Professional	TC	$112.89	$167.91	$354.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $140.11 / $190.36 / $247.47	Professional		$140.11	$190.36	$247.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $57.74 / $75.06	Professional	26	$44.02	$57.74	$75.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $96.08 / $132.62 / $169.53	Professional	TC	$96.08	$132.62	$169.53