Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $40.54 / $55.37 / $80.69	Facility	26	$40.54	$55.37	$80.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.32 / $313.58 / $758.88	Professional		$267.32	$313.58	$758.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $40.54 / $43.47 / $119.85	Professional	26	$40.54	$43.47	$119.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $223.84 / $271.54 / $657.12	Professional	TC	$223.84	$271.54	$657.12
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $290.91 / $338.98 / $389.83	Professional		$290.91	$338.98	$389.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.80 / $51.80 / $84.51	Professional	26	$51.80	$51.80	$84.51
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $244.29 / $287.18 / $324.51	Professional	TC	$244.29	$287.18	$324.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $249.88 / $408.76 / $869.11	Professional		$249.88	$408.76	$869.11
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.76 / $53.54 / $125.37	Professional	26	$36.76	$53.54	$125.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $213.09 / $358.97 / $743.74	Professional	TC	$213.09	$358.97	$743.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $306.89 / $382.38 / $708.12	Professional		$306.89	$382.38	$708.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $46.15 / $57.36 / $97.58	Professional	26	$46.15	$57.36	$97.58
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $261.72 / $319.39 / $608.36	Professional	TC	$261.72	$319.39	$608.36
United Facility/Professional Professional Modifier Low / Median / High Price $232.54 / $344.45 / $704.51	Professional		$232.54	$344.45	$704.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.11 / $45.43 / $106.46	Professional	26	$37.11	$45.43	$106.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $198.52 / $333.06 / $783.39	Professional	TC	$198.52	$333.06	$783.39
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $258.44 / $286.83 / $458.07	Professional		$258.44	$286.83	$458.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.04 / $42.22 / $64.84	Professional	26	$38.04	$42.22	$64.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $220.39 / $244.61 / $388.85	Professional	TC	$220.39	$244.61	$388.85