Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.81 / $84.97 / $91.17	Facility	26	$70.81	$84.97	$91.17
Aetna Facility/Professional Professional Modifier Low / Median / High Price $125.40 / $151.37 / $332.58	Professional		$125.40	$151.37	$332.58
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.68 / $80.73 / $167.91	Professional	26	$70.68	$80.73	$167.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $53.29 / $61.31 / $101.25	Professional	TC	$53.29	$61.31	$101.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $118.69 / $131.88 / $237.38	Professional		$118.69	$131.88	$237.38
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.05 / $72.28 / $130.10	Professional	26	$65.05	$72.28	$130.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $53.64 / $59.60 / $107.28	Professional	TC	$53.64	$59.60	$107.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.55 / $175.68 / $328.73	Professional		$102.55	$175.68	$328.73
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.61 / $109.44 / $199.85	Professional	26	$69.61	$109.44	$199.85
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.94 / $87.13 / $154.66	Professional	TC	$48.94	$87.13	$154.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.05 / $149.68 / $204.11	Professional		$102.05	$149.68	$204.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.85 / $86.31 / $117.69	Professional	26	$58.85	$86.31	$117.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $43.21 / $63.61 / $86.42	Professional	TC	$43.21	$63.61	$86.42
United Facility/Professional Professional Modifier Low / Median / High Price $118.95 / $170.74 / $347.27	Professional		$118.95	$170.74	$347.27
United Facility/Professional Professional Modifier 26 Low / Median / High Price $63.71 / $87.61 / $155.21	Professional	26	$63.71	$87.61	$155.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $52.54 / $74.52 / $126.61	Professional	TC	$52.54	$74.52	$126.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $119.38 / $156.22 / $195.29	Professional		$119.38	$156.22	$195.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.83 / $90.23 / $113.97	Professional	26	$68.83	$90.23	$113.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $50.55 / $65.05 / $81.31	Professional	TC	$50.55	$65.05	$81.31