Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $38.82 / $53.01 / $77.27	Facility	26	$38.82	$53.01	$77.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $188.86 / $228.16 / $333.70	Professional		$188.86	$228.16	$333.70
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.83 / $42.77 / $77.27	Professional	26	$38.83	$42.77	$77.27
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.38 / $185.40 / $300.06	Professional	TC	$143.38	$185.40	$300.06
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $257.70 / $257.70 / $291.66	Professional		$257.70	$257.70	$291.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $49.99 / $49.99 / $56.49	Professional	26	$49.99	$49.99	$56.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $207.72 / $207.72 / $238.54	Professional	TC	$207.72	$207.72	$238.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $271.16 / $575.91	Professional		$165.99	$271.16	$575.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.14 / $52.08 / $119.86	Professional	26	$35.14	$52.08	$119.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $130.77 / $219.08 / $456.05	Professional	TC	$130.77	$219.08	$456.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $203.87 / $271.27 / $468.66	Professional		$203.87	$271.27	$468.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.18 / $54.90 / $94.20	Professional	26	$44.18	$54.90	$94.20
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 $187.46 / $243.64 / $414.26	Professional		$187.46	$243.64	$414.26
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.07 / $43.51 / $80.98	Professional	26	$36.07	$43.51	$80.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.13 / $188.51 / $329.79	Professional	TC	$151.13	$188.51	$329.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $171.68 / $210.69 / $304.63	Professional		$171.68	$210.69	$304.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.42 / $44.71 / $62.06	Professional	26	$36.42	$44.71	$62.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $135.26 / $165.98 / $238.52	Professional	TC	$135.26	$165.98	$238.52