Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.25 / $54.25 / $74.34	Facility	26	$54.25	$54.25	$74.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $280.06 / $308.87 / $532.11	Professional		$280.06	$308.87	$532.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.25 / $57.15 / $141.05	Professional	26	$54.25	$57.15	$141.05
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $225.81 / $251.71 / $449.36	Professional	TC	$225.81	$251.71	$449.36
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $393.65 / $393.65 / $756.35	Professional		$393.65	$393.65	$756.35
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $71.18 / $71.18 / $81.86	Professional	26	$71.18	$71.18	$81.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $322.47 / $322.47 / $619.59	Professional	TC	$322.47	$322.47	$619.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.06 / $398.08 / $857.04	Professional		$246.06	$398.08	$857.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.16 / $72.68 / $167.65	Professional	26	$49.16	$72.68	$167.65
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $196.85 / $330.74 / $689.39	Professional	TC	$196.85	$330.74	$689.39
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $302.20 / $382.66 / $695.74	Professional		$302.20	$382.66	$695.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $61.88 / $74.26 / $131.13	Professional	26	$61.88	$74.26	$131.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $241.78 / $309.16 / $562.10	Professional	TC	$241.78	$309.16	$562.10
United Facility/Professional Professional Modifier Low / Median / High Price $271.51 / $367.21 / $612.85	Professional		$271.51	$367.21	$612.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.46 / $80.16 / $128.11	Professional	26	$53.46	$80.16	$128.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $220.81 / $289.37 / $496.03	Professional	TC	$220.81	$289.37	$496.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.49 / $280.49 / $452.10	Professional		$254.49	$280.49	$452.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $50.89 / $56.10 / $86.87	Professional	26	$50.89	$56.10	$86.87
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $203.60 / $224.39 / $359.28	Professional	TC	$203.60	$224.39	$359.28