Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.54 / $36.54 / $36.54	Facility	26	$36.54	$36.54	$36.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.10 / $201.13 / $255.00	Professional		$180.10	$201.13	$255.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $141.66 / $163.26 / $204.57	Professional	TC	$141.66	$163.26	$204.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $257.64 / $257.64 / $280.83	Professional		$257.64	$257.64	$280.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $209.77 / $209.77 / $228.65	Professional	TC	$209.77	$209.77	$228.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $164.19 / $263.41 / $562.24	Professional		$164.19	$263.41	$562.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.77 / $216.29 / $450.55	Professional	TC	$130.77	$216.29	$450.55
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $201.66 / $273.83 / $463.78	Professional		$201.66	$273.83	$463.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.89 / $52.10 / $88.66	Professional	26	$41.89	$52.10	$88.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $160.62 / $218.10 / $373.16	Professional	TC	$160.62	$218.10	$373.16
United Facility/Professional Professional Modifier Low / Median / High Price $181.96 / $230.61 / $406.80	Professional		$181.96	$230.61	$406.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $149.90 / $202.31 / $591.08	Professional	TC	$149.90	$202.31	$591.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $207.84 / $301.35	Professional		$169.82	$207.84	$301.35
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $135.26 / $165.54 / $238.52	Professional	TC	$135.26	$165.54	$238.52