Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.73 / $43.94 / $48.62	Facility	26	$41.73	$43.94	$48.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.96 / $213.02 / $645.00	Professional		$179.96	$213.02	$645.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.37 / $40.24 / $106.82	Professional	26	$28.37	$40.24	$106.82
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $145.97 / $170.08 / $432.90	Professional	TC	$145.97	$170.08	$432.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $182.09 / $202.32 / $258.97	Professional		$182.09	$202.32	$258.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.52 / $35.10 / $47.27	Professional	26	$31.52	$35.10	$47.27
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $150.49 / $167.21 / $214.03	Professional	TC	$150.49	$167.21	$214.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $183.14 / $271.91 / $432.96	Professional		$183.14	$271.91	$432.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $29.31 / $45.13 / $82.29	Professional	26	$29.31	$45.13	$82.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.58 / $235.01 / $354.44	Professional	TC	$146.58	$235.01	$354.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $195.14 / $251.73 / $362.66	Professional		$195.14	$251.73	$362.66
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.26 / $48.26 / $63.54	Professional	26	$37.26	$48.26	$63.54
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $157.13 / $202.71 / $299.12	Professional	TC	$157.13	$202.71	$299.12
United Facility/Professional Professional Modifier Low / Median / High Price $177.19 / $258.58 / $420.83	Professional		$177.19	$258.58	$420.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.36 / $40.75 / $76.39	Professional	26	$25.36	$40.75	$76.39
United Facility/Professional Professional Modifier TC Low / Median / High Price $142.69 / $226.67 / $399.55	Professional	TC	$142.69	$226.67	$399.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $162.13 / $224.41 / $277.07	Professional		$162.13	$224.41	$277.07
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.57 / $43.70 / $54.93	Professional	26	$31.57	$43.70	$54.93
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $130.56 / $180.71 / $225.52	Professional	TC	$130.56	$180.71	$225.52