Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.89 / $70.70 / $109.25	Facility	26	$54.89	$70.70	$109.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.90 / $253.50 / $834.00	Professional		$206.90	$253.50	$834.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.37 / $70.00 / $281.00	Professional	26	$56.37	$70.00	$281.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $152.00 / $165.55 / $449.34	Professional	TC	$152.00	$165.55	$449.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $215.09 / $235.02 / $300.83	Professional		$215.09	$235.02	$300.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.51 / $68.34 / $87.48	Professional	26	$61.51	$68.34	$87.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $146.74 / $166.68 / $213.35	Professional	TC	$146.74	$166.68	$213.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $210.67 / $299.08 / $589.66	Professional		$210.67	$299.08	$589.66
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.20 / $84.54 / $160.77	Professional	26	$59.20	$84.54	$160.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $153.29 / $222.88 / $458.38	Professional	TC	$153.29	$222.88	$458.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $222.99 / $287.66 / $419.28	Professional		$222.99	$287.66	$419.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.63 / $77.00 / $117.12	Professional	26	$60.63	$77.00	$117.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $162.37 / $209.46 / $317.45	Professional	TC	$162.37	$209.46	$317.45
United Facility/Professional Professional Modifier Low / Median / High Price $187.02 / $257.32 / $472.56	Professional		$187.02	$257.32	$472.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $70.53 / $130.13	Professional	26	$51.24	$70.53	$130.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $133.97 / $198.35 / $380.60	Professional	TC	$133.97	$198.35	$380.60
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $188.47 / $256.44 / $317.57	Professional		$188.47	$256.44	$317.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.24 / $69.72 / $88.40	Professional	26	$51.24	$69.72	$88.40
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $137.22 / $186.73 / $233.05	Professional	TC	$137.22	$186.73	$233.05