Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.72 / $89.14 / $130.78	Facility	26	$65.72	$89.14	$130.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $203.69 / $340.04 / $1,122.65	Professional		$203.69	$340.04	$1,122.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.17 / $74.27 / $194.18	Professional	26	$62.17	$74.27	$194.18
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $137.97 / $220.00 / $533.92	Professional	TC	$137.97	$220.00	$533.92
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $310.05 / $344.50 / $389.83	Professional		$310.05	$344.50	$389.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $69.08 / $75.65 / $98.80	Professional	26	$69.08	$75.65	$98.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $216.16 / $268.85 / $304.23	Professional	TC	$216.16	$268.85	$304.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $196.84 / $369.69 / $618.12	Professional		$196.84	$369.69	$618.12
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.94 / $85.01 / $160.15	Professional	26	$58.94	$85.01	$160.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $135.09 / $271.74 / $446.34	Professional	TC	$135.09	$271.74	$446.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $231.96 / $299.23 / $503.92	Professional		$231.96	$299.23	$503.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.05 / $88.14 / $126.78	Professional	26	$75.05	$88.14	$126.78
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $155.32 / $200.36 / $361.81	Professional	TC	$155.32	$200.36	$361.81
United Facility/Professional Professional Modifier Low / Median / High Price $174.85 / $298.39 / $529.65	Professional		$174.85	$298.39	$529.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.98 / $78.26 / $136.55	Professional	26	$40.98	$78.26	$136.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.22 / $190.59 / $384.83	Professional	TC	$132.22	$190.59	$384.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $185.57 / $251.96 / $327.55	Professional		$185.57	$251.96	$327.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.31 / $80.40 / $104.52	Professional	26	$61.31	$80.40	$104.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $124.26 / $171.56 / $219.33	Professional	TC	$124.26	$171.56	$219.33