Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.56 / $70.56 / $70.56	Facility	26	$70.56	$70.56	$70.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $207.46 / $275.00 / $793.27	Professional		$207.46	$275.00	$793.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.56 / $84.43 / $214.50	Professional	26	$70.56	$84.43	$214.50
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $136.90 / $191.62 / $366.89	Professional	TC	$136.90	$191.62	$366.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $296.98 / $329.98 / $419.07	Professional		$296.98	$329.98	$419.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $90.10 / $90.10 / $115.33	Professional	26	$90.10	$90.10	$115.33
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $215.89 / $239.88 / $304.64	Professional	TC	$215.89	$239.88	$304.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $332.24 / $636.03	Professional		$198.22	$332.24	$636.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.68 / $97.10 / $192.29	Professional	26	$63.68	$97.10	$192.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.79 / $227.84 / $420.06	Professional	TC	$130.79	$227.84	$420.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.46 / $308.89 / $475.26	Professional		$239.46	$308.89	$475.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.20 / $95.93 / $134.15	Professional	26	$81.20	$95.93	$134.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.13 / $202.71 / $341.11	Professional	TC	$157.13	$202.71	$341.11
United Facility/Professional Professional Modifier Low / Median / High Price $166.76 / $283.76 / $481.08	Professional		$166.76	$283.76	$481.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.48 / $86.75 / $152.38	Professional	26	$41.48	$86.75	$152.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $120.16 / $201.77 / $413.96	Professional	TC	$120.16	$201.77	$413.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.57 / $259.87 / $337.83	Professional		$191.57	$259.87	$337.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $65.86 / $86.38 / $112.29	Professional	26	$65.86	$86.38	$112.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $125.71 / $173.48 / $221.77	Professional	TC	$125.71	$173.48	$221.77