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 / $70.79	Facility	26	$52.48	$63.10	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $263.03 / $933.25	Professional		$151.36	$263.03	$933.25
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $102.33 / $199.53	Professional	26	$57.54	$102.33	$199.53
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.33 / $154.88 / $416.87	Professional	TC	$93.33	$154.88	$416.87
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $190.55 / $229.09	Professional		$120.23	$190.55	$229.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $79.43 / $85.11	Professional	26	$66.07	$79.43	$85.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $112.20 / $144.54 / $169.82	Professional	TC	$112.20	$144.54	$169.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	26	$100.00	$100.00	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $245.47 / $416.87	Professional		$131.83	$245.47	$416.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $69.18 / $128.82	Professional	26	$46.77	$69.18	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $81.28 / $162.18 / $302.00	Professional	TC	$81.28	$162.18	$302.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $177.83 / $302.00	Professional		$154.88	$177.83	$302.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $67.61 / $91.20	Professional	26	$58.88	$67.61	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $112.20 / $213.80	Professional	TC	$95.50	$112.20	$213.80
United Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $204.17 / $363.08	Professional		$134.90	$204.17	$363.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $66.07 / $117.49	Professional	26	$36.31	$66.07	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $131.83 / $257.04	Professional	TC	$87.10	$131.83	$257.04
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $245.47	Professional		$158.49	$181.97	$245.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $70.79 / $93.33	Professional	26	$61.66	$70.79	$93.33
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $95.50 / $112.20 / $154.88	Professional	TC	$95.50	$112.20	$154.88