Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $65.98 / $126.00 / $250.74	Facility	26	$65.98	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $253.72 / $475.00 / $1,107.26	Professional		$253.72	$475.00	$1,107.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.15 / $140.00 / $349.88	Professional	26	$73.15	$140.00	$349.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $192.95 / $335.00 / $681.01	Professional	TC	$192.95	$335.00	$681.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $382.83 / $443.39 / $509.90	Professional		$382.83	$443.39	$509.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $57.61 / $65.30 / $78.44	Professional	26	$57.61	$65.30	$78.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $315.49 / $378.09 / $434.80	Professional	TC	$315.49	$378.09	$434.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $193.80 / $470.52 / $818.98	Professional		$193.80	$470.52	$818.98
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.86 / $67.56 / $133.07	Professional	26	$43.86	$67.56	$133.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $147.88 / $367.12 / $672.43	Professional	TC	$147.88	$367.12	$672.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.09 / $292.95 / $495.26	Professional		$227.09	$292.95	$495.26
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $55.93 / $68.04 / $99.90	Professional	26	$55.93	$68.04	$99.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $170.39 / $219.80 / $409.21	Professional	TC	$170.39	$219.80	$409.21
United Facility/Professional Professional Modifier Low / Median / High Price $207.73 / $296.76 / $783.97	Professional		$207.73	$296.76	$783.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.11 / $61.35 / $125.42	Professional	26	$35.11	$61.35	$125.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $160.41 / $246.77 / $615.50	Professional	TC	$160.41	$246.77	$615.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $181.67 / $247.63 / $321.92	Professional		$181.67	$247.63	$321.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.36 / $59.50 / $77.34	Professional	26	$45.36	$59.50	$77.34
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $136.31 / $188.14 / $240.50	Professional	TC	$136.31	$188.14	$240.50