Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $32.75 / $44.39 / $65.17	Facility	26	$32.75	$44.39	$65.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.22 / $262.62 / $601.15	Professional		$171.22	$262.62	$601.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.48 / $44.12 / $99.21	Professional	26	$31.48	$44.12	$99.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $140.87 / $228.41 / $459.70	Professional	TC	$140.87	$228.41	$459.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $215.33 / $271.57 / $344.89	Professional		$215.33	$271.57	$344.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $37.15 / $47.19	Professional	26	$37.15	$37.15	$47.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $178.17 / $234.42 / $289.22	Professional	TC	$178.17	$234.42	$289.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $197.04 / $295.56 / $737.48	Professional		$197.04	$295.56	$737.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.64 / $44.93 / $99.94	Professional	26	$29.64	$44.93	$99.94
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $168.95 / $242.68 / $636.63	Professional	TC	$168.95	$242.68	$636.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $223.65 / $337.59 / $587.54	Professional		$223.65	$337.59	$587.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $36.45 / $49.42 / $73.44	Professional	26	$36.45	$49.42	$73.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $183.55 / $293.05 / $514.13	Professional	TC	$183.55	$293.05	$514.13
United Facility/Professional Professional Modifier Low / Median / High Price $147.56 / $273.32 / $513.35	Professional		$147.56	$273.32	$513.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $26.93 / $42.32 / $88.01	Professional	26	$26.93	$42.32	$88.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.48 / $244.68 / $622.67	Professional	TC	$123.48	$244.68	$622.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $220.28 / $316.88 / $398.97	Professional		$220.28	$316.88	$398.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.20 / $44.06 / $52.64	Professional	26	$30.20	$44.06	$52.64
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $190.08 / $272.47 / $346.33	Professional	TC	$190.08	$272.47	$346.33