Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $42.25 / $57.74 / $84.09	Facility	26	$42.25	$57.74	$84.09
Aetna Facility/Professional Professional Modifier Low / Median / High Price $274.93 / $300.20 / $522.36	Professional		$274.93	$300.20	$522.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.26 / $44.02 / $109.88	Professional	26	$42.26	$44.02	$109.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $232.67 / $256.39 / $442.07	Professional	TC	$232.67	$256.39	$442.07
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.06 / $352.06 / $404.87	Professional		$352.06	$352.06	$404.87
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.40 / $54.40 / $67.92	Professional	26	$54.40	$54.40	$67.92
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $297.66 / $297.66 / $342.31	Professional	TC	$297.66	$297.66	$342.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.69 / $394.39 / $831.95	Professional		$238.69	$394.39	$831.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.29 / $56.47 / $130.63	Professional	26	$38.29	$56.47	$130.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.36 / $339.72 / $701.32	Professional	TC	$200.36	$339.72	$701.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $291.91 / $365.08 / $676.08	Professional		$291.91	$365.08	$676.08
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.07 / $57.18 / $103.17	Professional	26	$47.07	$57.18	$103.17
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $243.80 / $308.94 / $572.12	Professional	TC	$243.80	$308.94	$572.12
United Facility/Professional Professional Modifier Low / Median / High Price $256.20 / $344.84 / $866.89	Professional		$256.20	$344.84	$866.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.92 / $48.17 / $91.78	Professional	26	$36.92	$48.17	$91.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $217.81 / $290.52 / $510.48	Professional	TC	$217.81	$290.52	$510.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $246.86 / $279.02 / $437.87	Professional		$246.86	$279.02	$437.87
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.64 / $44.81 / $67.56	Professional	26	$39.64	$44.81	$67.56
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $207.22 / $234.22 / $365.70	Professional	TC	$207.22	$234.22	$365.70