Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $78.68 / $78.68 / $110.75	Facility	26	$78.68	$78.68	$110.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $142.94 / $197.55 / $510.40	Professional		$142.94	$197.55	$510.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.82 / $80.84 / $230.39	Professional	26	$56.82	$80.84	$230.39
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $64.27 / $122.11 / $387.01	Professional	TC	$64.27	$122.11	$387.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $193.39 / $193.39 / $591.98	Professional		$193.39	$193.39	$591.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $63.63 / $100.07 / $113.23	Professional	26	$63.63	$100.07	$113.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.32 / $93.32 / $528.35	Professional	TC	$93.32	$93.32	$528.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.82 / $248.39 / $576.27	Professional		$129.82	$248.39	$576.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.66 / $89.45 / $197.95	Professional	26	$60.66	$89.45	$197.95
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.83 / $126.80 / $361.53	Professional	TC	$57.83	$126.80	$361.53
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.84 / $216.51 / $357.98	Professional		$167.84	$216.51	$357.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.05 / $107.03 / $151.08	Professional	26	$76.05	$107.03	$151.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $74.77 / $96.45 / $221.78	Professional	TC	$74.77	$96.45	$221.78
United Facility/Professional Professional Modifier Low / Median / High Price $153.52 / $244.68 / $475.47	Professional		$153.52	$244.68	$475.47
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.83 / $86.06 / $168.05	Professional	26	$51.83	$86.06	$168.05
United Facility/Professional Professional Modifier TC Low / Median / High Price $70.62 / $116.82 / $334.91	Professional	TC	$70.62	$116.82	$334.91
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $134.27 / $178.99 / $239.20	Professional		$134.27	$178.99	$239.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $74.45 / $98.09 / $133.76	Professional	26	$74.45	$98.09	$133.76
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $59.82 / $82.50 / $105.45	Professional	TC	$59.82	$82.50	$105.45