Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.85 / $27.09 / $39.50	Facility	26	$19.85	$27.09	$39.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.22 / $221.90 / $342.57	Professional		$198.22	$221.90	$342.57
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.85 / $20.60 / $51.04	Professional	26	$19.85	$20.60	$51.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.37 / $201.28 / $304.51	Professional	TC	$178.37	$201.28	$304.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $269.42 / $269.42 / $309.83	Professional		$269.42	$269.42	$309.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $25.94 / $25.94 / $29.83	Professional	26	$25.94	$25.94	$29.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $243.48 / $243.48 / $280.00	Professional	TC	$243.48	$243.48	$280.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $172.51 / $285.69 / $598.08	Professional		$172.51	$285.69	$598.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $26.40 / $60.34	Professional	26	$17.80	$26.40	$60.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.51 / $259.29 / $537.74	Professional	TC	$154.51	$259.29	$537.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $210.51 / $264.51 / $489.84	Professional		$210.51	$264.51	$489.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $22.11 / $26.85 / $48.15	Professional	26	$22.11	$26.85	$48.15
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $187.93 / $238.16 / $441.04	Professional	TC	$187.93	$238.16	$441.04
United Facility/Professional Professional Modifier Low / Median / High Price $193.61 / $261.64 / $492.37	Professional		$193.61	$261.64	$492.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $18.30 / $24.26 / $56.98	Professional	26	$18.30	$24.26	$56.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.36 / $222.67 / $396.06	Professional	TC	$169.36	$222.67	$396.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $178.42 / $210.79 / $315.77	Professional		$178.42	$210.79	$315.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $18.62 / $21.99 / $31.73	Professional	26	$18.62	$21.99	$31.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $159.80 / $188.80 / $281.89	Professional	TC	$159.80	$188.80	$281.89