Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.01 / $50.41 / $56.95	Facility	26	$42.01	$50.41	$56.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.61 / $149.26 / $344.84	Professional		$127.61	$149.26	$344.84
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $33.21 / $43.61 / $138.56	Professional	26	$33.21	$43.61	$138.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $89.24 / $105.65 / $252.54	Professional	TC	$89.24	$105.65	$252.54
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $129.21 / $156.71 / $199.02	Professional		$129.21	$156.71	$199.02
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $35.96 / $44.80 / $56.90	Professional	26	$35.96	$44.80	$56.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.24 / $111.91 / $142.13	Professional	TC	$93.24	$111.91	$142.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.02 / $164.34 / $325.29	Professional		$117.02	$164.34	$325.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.93 / $45.86 / $106.79	Professional	26	$31.93	$45.86	$106.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $82.00 / $129.53 / $252.32	Professional	TC	$82.00	$129.53	$252.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $143.47 / $179.43 / $278.12	Professional		$143.47	$179.43	$278.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $39.74 / $56.25 / $73.37	Professional	26	$39.74	$56.25	$73.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $100.61 / $124.28 / $197.38	Professional	TC	$100.61	$124.28	$197.38
United Facility/Professional Professional Modifier Low / Median / High Price $106.74 / $156.63 / $283.52	Professional		$106.74	$156.63	$283.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $27.01 / $46.74 / $90.63	Professional	26	$27.01	$46.74	$90.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.63 / $103.58 / $193.95	Professional	TC	$78.63	$103.58	$193.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $116.59 / $169.70 / $222.51	Professional		$116.59	$169.70	$222.51
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.54 / $52.21 / $71.19	Professional	26	$36.54	$52.21	$71.19
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $80.04 / $118.36 / $151.32	Professional	TC	$80.04	$118.36	$151.32