Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $41.12 / $43.97 / $68.19	Facility	26	$41.12	$43.97	$68.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.33 / $232.99 / $808.75	Professional		$144.33	$232.99	$808.75
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $63.40 / $207.97	Professional	26	$35.11	$63.40	$207.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $100.23 / $166.96 / $335.01	Professional	TC	$100.23	$166.96	$335.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $185.22 / $208.17 / $266.45	Professional		$185.22	$208.17	$266.45
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.81 / $45.10 / $65.84	Professional	26	$40.81	$45.10	$65.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $144.41 / $163.08 / $207.11	Professional	TC	$144.41	$163.08	$207.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $154.26 / $232.59 / $357.51	Professional		$154.26	$232.59	$357.51
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $36.32 / $58.86 / $106.63	Professional	26	$36.32	$58.86	$106.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $117.45 / $175.60 / $279.31	Professional	TC	$117.45	$175.60	$279.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $163.96 / $211.51 / $299.61	Professional		$163.96	$211.51	$299.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $48.83 / $77.80	Professional	26	$37.85	$48.83	$77.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $126.10 / $162.66 / $233.36	Professional	TC	$126.10	$162.66	$233.36
United Facility/Professional Professional Modifier Low / Median / High Price $150.97 / $211.82 / $345.61	Professional		$150.97	$211.82	$345.61
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.94 / $53.92 / $96.41	Professional	26	$35.94	$53.92	$96.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.81 / $160.72 / $264.47	Professional	TC	$114.81	$160.72	$264.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $152.80 / $175.72 / $217.10	Professional		$152.80	$175.72	$217.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.85 / $43.53 / $54.97	Professional	26	$37.85	$43.53	$54.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $114.94 / $132.18 / $164.88	Professional	TC	$114.94	$132.18	$164.88