Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $63.10 / $63.10	Facility	26	$52.48	$63.10	$63.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $295.12 / $1,071.52	Professional		$173.78	$295.12	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $102.33 / $218.78	Professional	26	$56.23	$102.33	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $194.98 / $416.87	Professional	TC	$114.82	$194.98	$416.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $223.87 / $316.23	Professional		$104.71	$223.87	$316.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $77.62 / $89.13	Professional	26	$69.18	$77.62	$89.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $169.82 / $229.09	Professional	TC	$151.36	$169.82	$229.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $281.84 / $489.78	Professional		$151.36	$281.84	$489.78
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $128.82	Professional	26	$46.77	$70.79	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $102.33 / $190.55 / $363.08	Professional	TC	$102.33	$190.55	$363.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $371.54	Professional		$177.83	$208.93	$371.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $91.20	Professional	26	$58.88	$66.07	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $141.25 / $269.15	Professional	TC	$120.23	$141.25	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $245.47 / $446.68	Professional		$154.88	$245.47	$446.68
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $114.82	Professional	26	$36.31	$64.57	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $169.82 / $331.13	Professional	TC	$109.65	$169.82	$331.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $213.80 / $288.40	Professional		$181.97	$213.80	$288.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.26 / $69.18 / $91.20	Professional	26	$60.26	$69.18	$91.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $141.25 / $194.98	Professional	TC	$123.03	$141.25	$194.98