Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.28 / $48.34 / $55.21	Facility	26	$40.28	$48.34	$55.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $182.14 / $718.40	Professional		$140.00	$182.14	$718.40
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $52.38 / $123.75	Professional	26	$41.17	$52.38	$123.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.71 / $120.78 / $296.19	Professional	TC	$99.71	$120.78	$296.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $181.25 / $181.25 / $218.96	Professional		$181.25	$181.25	$218.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $50.33 / $52.61 / $60.13	Professional	26	$50.33	$52.61	$60.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $128.63 / $128.63 / $158.90	Professional	TC	$128.63	$128.63	$158.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.01 / $194.83 / $370.92	Professional		$127.01	$194.83	$370.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.52 / $55.99 / $109.51	Professional	26	$36.52	$55.99	$109.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $90.47 / $142.88 / $263.58	Professional	TC	$90.47	$142.88	$263.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.68 / $196.60 / $284.66	Professional		$163.68	$196.60	$284.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.61 / $54.54 / $78.02	Professional	26	$46.61	$54.54	$78.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $116.24 / $140.35 / $206.64	Professional	TC	$116.24	$140.35	$206.64
United Facility/Professional Professional Modifier Low / Median / High Price $140.72 / $193.47 / $415.05	Professional		$140.72	$193.47	$415.05
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.84 / $54.05 / $87.58	Professional	26	$37.84	$54.05	$87.58
United Facility/Professional Professional Modifier TC Low / Median / High Price $96.43 / $127.49 / $207.78	Professional	TC	$96.43	$127.49	$207.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.36 / $178.73 / $233.83	Professional		$131.36	$178.73	$233.83
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.79 / $50.40 / $68.73	Professional	26	$37.79	$50.40	$68.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $93.57 / $129.15 / $165.11	Professional	TC	$93.57	$129.15	$165.11