Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.29 / $70.79 / $72.44	Facility	26	$51.29	$70.79	$72.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $398.11 / $1,479.11	Professional		$117.49	$398.11	$1,479.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $295.12 / $954.99	Professional	26	$60.26	$295.12	$954.99
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $102.33 / $380.19	Professional	TC	$57.54	$102.33	$380.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $125.89 / $281.84	Professional		$64.57	$125.89	$281.84
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $74.13 / $162.18	Professional	26	$57.54	$74.13	$162.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $75.86 / $102.33	Professional	TC	$67.61	$75.86	$102.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $165.96 / $338.84	Professional		$100.00	$165.96	$338.84
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $72.44 / $162.18	Professional	26	$46.77	$72.44	$162.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $102.33 / $181.97	Professional	TC	$52.48	$102.33	$181.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $158.49 / $263.03	Professional		$128.82	$158.49	$263.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $104.71	Professional	26	$61.66	$70.79	$104.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $85.11 / $144.54	Professional	TC	$67.61	$85.11	$144.54
United Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $251.19	Professional		$112.20	$158.49	$251.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $63.10 / $109.65	Professional	26	$44.67	$63.10	$109.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $58.88 / $91.20 / $158.49	Professional	TC	$58.88	$91.20	$158.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $199.53	Professional		$131.83	$154.88	$199.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $72.44 / $91.20	Professional	26	$61.66	$72.44	$91.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $69.18 / $81.28 / $109.65	Professional	TC	$69.18	$81.28	$109.65