Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $31.69 / $43.18 / $63.08	Facility	26	$31.69	$43.18	$63.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.87 / $289.66 / $548.44	Professional		$251.87	$289.66	$548.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $38.17 / $89.04	Professional	26	$31.70	$38.17	$89.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $251.51 / $485.04	Professional	TC	$218.71	$251.51	$485.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $278.25 / $323.43 / $365.48	Professional		$278.25	$323.43	$365.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.70 / $40.70 / $46.80	Professional	26	$40.70	$40.70	$46.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $241.61 / $282.73 / $319.48	Professional	TC	$241.61	$282.73	$319.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.88 / $395.56 / $829.66	Professional		$238.88	$395.56	$829.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.44 / $42.16 / $96.93	Professional	26	$28.44	$42.16	$96.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.13 / $353.41 / $732.73	Professional	TC	$210.13	$353.41	$732.73
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $293.39 / $355.81 / $677.74	Professional		$293.39	$355.81	$677.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.99 / $43.98 / $75.59	Professional	26	$35.99	$43.98	$75.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.01 / $314.93 / $599.86	Professional	TC	$257.01	$314.93	$599.86
United Facility/Professional Professional Modifier Low / Median / High Price $193.00 / $331.81 / $599.46	Professional		$193.00	$331.81	$599.46
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.49 / $34.90 / $73.62	Professional	26	$28.49	$34.90	$73.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $167.01 / $296.89 / $961.44	Professional	TC	$167.01	$296.89	$961.44
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $247.06 / $279.25 / $437.42	Professional		$247.06	$279.25	$437.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.74 / $33.61 / $50.61	Professional	26	$29.74	$33.61	$50.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $217.33 / $245.63 / $383.42	Professional	TC	$217.33	$245.63	$383.42