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 / $102.33	Facility	26	$52.48	$63.10	$102.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $302.00 / $1,174.90	Professional		$181.97	$302.00	$1,174.90
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $85.11 / $186.21	Professional	26	$54.95	$85.11	$186.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $120.23 / $199.53 / $478.63	Professional	TC	$120.23	$199.53	$478.63
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $234.42 / $302.00	Professional		$165.96	$234.42	$302.00
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 $165.96 / $186.21 / $257.04	Professional	TC	$165.96	$186.21	$257.04
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 $162.18 / $309.03 / $575.44	Professional		$162.18	$309.03	$575.44
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $75.86 / $138.04	Professional	26	$46.77	$75.86	$138.04
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $218.78 / $416.87	Professional	TC	$112.20	$218.78	$416.87
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $223.87 / $426.58	Professional		$190.55	$223.87	$426.58
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 $131.83 / $154.88 / $316.23	Professional	TC	$131.83	$154.88	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $269.15 / $489.78	Professional		$169.82	$269.15	$489.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $66.07 / $114.82	Professional	26	$39.81	$66.07	$114.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.03 / $186.21 / $380.19	Professional	TC	$123.03	$186.21	$380.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $223.87 / $309.03	Professional		$194.98	$223.87	$309.03
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 $131.83 / $154.88 / $213.80	Professional	TC	$131.83	$154.88	$213.80