Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.65 / $70.79 / $102.80	Facility	26	$51.65	$70.79	$102.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.61 / $167.10 / $866.22	Professional		$109.61	$167.10	$866.22
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.67 / $101.62 / $691.44	Professional	26	$53.67	$101.62	$691.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.94 / $89.90 / $210.86	Professional	TC	$57.94	$89.90	$210.86
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $148.55 / $148.55 / $247.47	Professional		$148.55	$148.55	$247.47
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.77 / $68.12 / $86.51	Professional	26	$65.77	$68.12	$86.51
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.43 / $80.43 / $164.03	Professional	TC	$80.43	$80.43	$164.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.11 / $177.37 / $344.88	Professional		$101.11	$177.37	$344.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.65 / $72.17 / $160.52	Professional	26	$47.65	$72.17	$160.52
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $53.46 / $103.42 / $181.89	Professional	TC	$53.46	$103.42	$181.89
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $168.63 / $288.26	Professional		$130.72	$168.63	$288.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $79.45 / $119.01	Professional	26	$61.60	$79.45	$119.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.12 / $89.86 / $158.86	Professional	TC	$69.12	$89.86	$158.86
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $154.28 / $227.46	Professional		$112.20	$154.28	$227.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.15 / $66.27 / $169.82	Professional	26	$45.15	$66.27	$169.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $59.18 / $89.65 / $132.28	Professional	TC	$59.18	$89.65	$132.28
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $130.72 / $149.60 / $183.90	Professional		$130.72	$149.60	$183.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.60 / $70.84 / $84.66	Professional	26	$61.60	$70.84	$84.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $69.12 / $78.06 / $99.24	Professional	TC	$69.12	$78.06	$99.24