Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $71.56 / $96.61 / $142.44	Facility	26	$71.56	$96.61	$142.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $230.50 / $385.88 / $1,173.46	Professional		$230.50	$385.88	$1,173.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.09 / $88.86 / $315.26	Professional	26	$72.09	$88.86	$315.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $292.37 / $939.55	Professional	TC	$158.91	$292.37	$939.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $386.46 / $404.91 / $526.63	Professional		$386.46	$404.91	$526.63
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.70 / $91.20 / $118.56	Professional	26	$83.70	$91.20	$118.56
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $287.08 / $313.70 / $412.20	Professional	TC	$287.08	$313.70	$412.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.39 / $496.49 / $859.33	Professional		$246.39	$496.49	$859.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.27 / $97.78 / $191.63	Professional	26	$64.27	$97.78	$191.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $179.43 / $362.27 / $726.18	Professional	TC	$179.43	$362.27	$726.18
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $290.79 / $375.12 / $592.91	Professional		$290.79	$375.12	$592.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.92 / $99.71 / $147.60	Professional	26	$81.92	$99.71	$147.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $207.70 / $267.93 / $439.85	Professional	TC	$207.70	$267.93	$439.85
United Facility/Professional Professional Modifier Low / Median / High Price $249.80 / $358.66 / $764.93	Professional		$249.80	$358.66	$764.93
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.88 / $85.99 / $146.68	Professional	26	$41.88	$85.99	$146.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $183.37 / $253.79 / $658.03	Professional	TC	$183.37	$253.79	$658.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $220.36 / $299.57 / $389.44	Professional		$220.36	$299.57	$389.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.47 / $87.15 / $113.30	Professional	26	$66.47	$87.15	$113.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.88 / $212.43 / $271.56	Professional	TC	$153.88	$212.43	$271.56