Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.15 / $65.16 / $88.36	Facility	26	$65.15	$65.16	$88.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $202.83 / $403.49 / $992.00	Professional		$202.83	$403.49	$992.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.16 / $89.92 / $174.62	Professional	26	$65.16	$89.92	$174.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.66 / $170.91 / $368.95	Professional	TC	$137.66	$170.91	$368.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $322.39 / $332.56 / $411.09	Professional		$322.39	$332.56	$411.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.32 / $86.32 / $109.63	Professional	26	$86.32	$86.32	$109.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $232.61 / $246.24 / $296.81	Professional	TC	$232.61	$246.24	$296.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.73 / $327.50 / $613.63	Professional		$193.73	$327.50	$613.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.77 / $90.15 / $177.16	Professional	26	$58.77	$90.15	$177.16
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.10 / $227.41 / $414.35	Professional	TC	$132.10	$227.41	$414.35
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $229.12 / $269.30 / $427.28	Professional		$229.12	$269.30	$427.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $74.93 / $87.68 / $123.80	Professional	26	$74.93	$87.68	$123.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $152.68 / $183.21 / $303.49	Professional	TC	$152.68	$183.21	$303.49
United Facility/Professional Professional Modifier Low / Median / High Price $221.18 / $363.79 / $952.00	Professional		$221.18	$363.79	$952.00
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.72 / $77.70 / $134.24	Professional	26	$40.72	$77.70	$134.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.38 / $256.89 / $856.79	Professional	TC	$148.38	$256.89	$856.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $183.64 / $249.35 / $324.16	Professional		$183.64	$249.35	$324.16
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.78 / $79.70 / $103.62	Professional	26	$60.78	$79.70	$103.62
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $122.86 / $169.64 / $216.86	Professional	TC	$122.86	$169.64	$216.86