Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.64 / $51.64 / $73.29	Facility	26	$51.64	$51.64	$73.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.09 / $272.64 / $1,122.76	Professional		$194.09	$272.64	$1,122.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.64 / $62.17 / $183.36	Professional	26	$51.64	$62.17	$183.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $142.44 / $192.00 / $930.89	Professional	TC	$142.44	$192.00	$930.89
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $322.69 / $424.01	Professional		$302.08	$322.69	$424.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $69.47 / $75.23 / $108.16	Professional	26	$69.47	$75.23	$108.16
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $224.24 / $247.45 / $322.39	Professional	TC	$224.24	$247.45	$322.39
Cigna Facility/Professional Professional Modifier Low / Median / High Price $188.80 / $369.69 / $632.07	Professional		$188.80	$369.69	$632.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.51 / $78.31 / $148.29	Professional	26	$46.51	$78.31	$148.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $140.15 / $296.27 / $484.29	Professional	TC	$140.15	$296.27	$484.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $221.03 / $285.13 / $481.54	Professional		$221.03	$285.13	$481.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.26 / $75.05 / $121.70	Professional	26	$59.26	$75.05	$121.70
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $160.90 / $207.56 / $398.67	Professional	TC	$160.90	$207.56	$398.67
United Facility/Professional Professional Modifier Low / Median / High Price $184.21 / $299.41 / $538.58	Professional		$184.21	$299.41	$538.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.22 / $64.59 / $115.06	Professional	26	$41.22	$64.59	$115.06
United Facility/Professional Professional Modifier TC Low / Median / High Price $152.80 / $238.44 / $490.63	Professional	TC	$152.80	$238.44	$490.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $176.82 / $240.77 / $313.00	Professional		$176.82	$240.77	$313.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.10 / $63.04 / $81.95	Professional	26	$48.10	$63.04	$81.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $128.72 / $177.73 / $227.22	Professional	TC	$128.72	$177.73	$227.22