Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $79.98 / $79.98 / $79.98	Facility	26	$79.98	$79.98	$79.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $127.85 / $135.80 / $433.56	Professional		$127.85	$135.80	$433.56
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $52.67 / $170.99	Professional	TC	$47.86	$52.67	$170.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $180.53 / $190.56 / $236.26	Professional		$180.53	$190.56	$236.26
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $67.97 / $70.26 / $124.86	Professional	TC	$67.97	$70.26	$124.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.02 / $187.68 / $373.60	Professional		$115.02	$187.68	$373.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $43.45 / $84.49 / $141.12	Professional	TC	$43.45	$84.49	$141.12
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $148.94 / $187.87 / $297.57	Professional		$148.94	$187.87	$297.57
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $92.56 / $116.94 / $191.38	Professional	26	$92.56	$116.94	$191.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $56.29 / $70.92 / $106.19	Professional	TC	$56.29	$70.92	$106.19
United Facility/Professional Professional Modifier Low / Median / High Price $126.38 / $169.32 / $274.91	Professional		$126.38	$169.32	$274.91
United Facility/Professional Professional Modifier TC Low / Median / High Price $45.65 / $68.47 / $102.30	Professional	TC	$45.65	$68.47	$102.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.25 / $171.29 / $207.34	Professional		$136.25	$171.29	$207.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $51.49 / $63.46 / $80.68	Professional	TC	$51.49	$63.46	$80.68