Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.98 / $126.05 / $183.06	Facility	26	$91.98	$126.05	$183.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.05 / $179.81 / $972.69	Professional		$121.05	$179.81	$972.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.92 / $106.28 / $278.00	Professional	26	$90.92	$106.28	$278.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $29.06 / $58.19 / $110.68	Professional	TC	$29.06	$58.19	$110.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $151.35 / $151.35 / $594.54	Professional		$151.35	$151.35	$594.54
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $111.90 / $120.06 / $152.47	Professional	26	$111.90	$120.06	$152.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $31.29 / $31.29 / $482.64	Professional	TC	$31.29	$31.29	$482.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.10 / $216.05 / $473.62	Professional		$115.10	$216.05	$473.62
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.63 / $127.52 / $283.63	Professional	26	$84.63	$127.52	$283.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $29.32 / $51.87 / $128.38	Professional	TC	$29.32	$51.87	$128.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $150.36 / $195.47 / $293.41	Professional		$150.36	$195.47	$293.41
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $109.40 / $141.15 / $209.62	Professional	26	$109.40	$141.15	$209.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $40.95 / $52.83 / $105.36	Professional	TC	$40.95	$52.83	$105.36
United Facility/Professional Professional Modifier Low / Median / High Price $116.38 / $196.29 / $553.33	Professional		$116.38	$196.29	$553.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $77.09 / $116.94 / $245.35	Professional	26	$77.09	$116.94	$245.35
United Facility/Professional Professional Modifier TC Low / Median / High Price $23.38 / $41.27 / $434.75	Professional	TC	$23.38	$41.27	$434.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $140.46 / $172.91 / $208.92	Professional		$140.46	$172.91	$208.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $102.21 / $125.83 / $150.29	Professional	26	$102.21	$125.83	$150.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $38.25 / $46.10 / $58.63	Professional	TC	$38.25	$46.10	$58.63