Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.29 / $96.21 / $141.88	Facility	26	$71.29	$96.21	$141.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $174.30 / $221.82 / $867.00	Professional		$174.30	$221.82	$867.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.30 / $89.51 / $285.25	Professional	26	$71.30	$89.51	$285.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $95.90 / $136.56 / $564.00	Professional	TC	$95.90	$136.56	$564.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $250.65 / $278.50 / $365.95	Professional		$250.65	$278.50	$365.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $90.48 / $90.48 / $117.62	Professional	26	$90.48	$90.48	$117.62
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $151.87 / $188.02 / $250.08	Professional	TC	$151.87	$188.02	$250.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.31 / $265.24 / $510.33	Professional		$160.31	$265.24	$510.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.02 / $100.02 / $194.53	Professional	26	$64.02	$100.02	$194.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.92 / $160.38 / $293.20	Professional	TC	$94.92	$160.38	$293.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $192.40 / $239.04 / $339.11	Professional		$192.40	$239.04	$339.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.59 / $99.82 / $181.70	Professional	26	$81.59	$99.82	$181.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $108.95 / $139.21 / $270.76	Professional	TC	$108.95	$139.21	$270.76
United Facility/Professional Professional Modifier Low / Median / High Price $120.76 / $203.18 / $351.12	Professional		$120.76	$203.18	$351.12
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.09 / $83.62 / $146.11	Professional	26	$44.09	$83.62	$146.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $76.67 / $123.03 / $205.90	Professional	TC	$76.67	$123.03	$205.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $207.86 / $270.22	Professional		$153.91	$207.86	$270.22
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.20 / $86.80 / $112.84	Professional	26	$66.20	$86.80	$112.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $87.71 / $121.05 / $154.76	Professional	TC	$87.71	$121.05	$154.76