Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $34.78 / $34.78 / $44.21	Facility	26	$34.78	$34.78	$44.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $235.26 / $273.08 / $446.99	Professional		$235.26	$273.08	$446.99
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.79 / $37.29 / $66.09	Professional	26	$34.79	$37.29	$66.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $200.47 / $236.99 / $380.89	Professional	TC	$200.47	$236.99	$380.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $261.67 / $261.67 / $295.69	Professional		$261.67	$261.67	$295.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $34.95 / $40.35	Professional	26	$34.95	$34.95	$40.35
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $225.67 / $226.72 / $256.19	Professional	TC	$225.67	$226.72	$256.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $234.95 / $355.57 / $564.58	Professional		$234.95	$355.57	$564.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $35.72 / $49.34 / $82.34	Professional	26	$35.72	$49.34	$82.34
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.51 / $305.72 / $485.92	Professional	TC	$202.51	$305.72	$485.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $257.11 / $323.07 / $488.69	Professional		$257.11	$323.07	$488.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $37.97 / $46.64 / $63.70	Professional	26	$37.97	$46.64	$63.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $218.23 / $272.79 / $424.99	Professional	TC	$218.23	$272.79	$424.99
United Facility/Professional Professional Modifier Low / Median / High Price $228.96 / $311.48 / $526.60	Professional		$228.96	$311.48	$526.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.42 / $43.20 / $74.69	Professional	26	$31.42	$43.20	$74.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.64 / $269.23 / $555.79	Professional	TC	$185.64	$269.23	$555.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $235.70 / $295.68 / $365.21	Professional		$235.70	$295.68	$365.21
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $35.64 / $44.70 / $55.28	Professional	26	$35.64	$44.70	$55.28
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $200.06 / $250.96 / $313.24	Professional	TC	$200.06	$250.96	$313.24