Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $36.31 / $36.31 / $36.31	Facility	26	$36.31	$36.31	$36.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $239.88 / $794.33	Professional		$173.78	$239.88	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $190.55 / $660.69	Professional	TC	$134.90	$190.55	$660.69
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $186.21 / $251.19	Professional		$45.71	$186.21	$251.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $204.17 / $251.19	Professional	TC	$165.96	$204.17	$251.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $251.19 / $457.09	Professional		$165.96	$251.19	$457.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $131.83 / $218.78 / $446.68	Professional	TC	$131.83	$218.78	$446.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $257.04 / $407.38	Professional		$204.17	$257.04	$407.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $50.12 / $77.62	Professional	26	$41.69	$50.12	$77.62
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $204.17 / $338.84	Professional	TC	$162.18	$204.17	$338.84
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $239.88 / $467.74	Professional		$181.97	$239.88	$467.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $199.53 / $380.19	Professional	TC	$154.88	$199.53	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $251.19 / $338.84	Professional		$208.93	$251.19	$338.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $275.42	Professional	TC	$165.96	$199.53	$275.42