Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $66.38 / $126.00 / $162.46	Facility	26	$66.38	$126.00	$162.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.10 / $475.00 / $1,140.23	Professional		$290.10	$475.00	$1,140.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $60.09 / $135.86 / $309.00	Professional	26	$60.09	$135.86	$309.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $202.01 / $335.00 / $801.32	Professional	TC	$202.01	$335.00	$801.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $383.47 / $390.65 / $484.36	Professional		$383.47	$390.65	$484.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $65.30 / $74.64	Professional	26	$57.22	$65.30	$74.64
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $316.13 / $325.35 / $421.69	Professional	TC	$316.13	$325.35	$421.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.10 / $469.38 / $819.64	Professional		$194.10	$469.38	$819.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.13 / $67.95 / $132.63	Professional	26	$44.13	$67.95	$132.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $148.18 / $367.43 / $672.99	Professional	TC	$148.18	$367.43	$672.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $227.79 / $293.85 / $496.80	Professional		$227.79	$293.85	$496.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.29 / $68.45 / $99.90	Professional	26	$56.29	$68.45	$99.90
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $170.74 / $220.25 / $409.21	Professional	TC	$170.74	$220.25	$409.21
United Facility/Professional Professional Modifier Low / Median / High Price $212.59 / $325.13 / $691.74	Professional		$212.59	$325.13	$691.74
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.93 / $61.71 / $101.14	Professional	26	$29.93	$61.71	$101.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $165.15 / $244.91 / $616.75	Professional	TC	$165.15	$244.91	$616.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $182.23 / $248.40 / $322.92	Professional		$182.23	$248.40	$322.92
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.64 / $59.88 / $77.84	Professional	26	$45.64	$59.88	$77.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $136.59 / $188.52 / $240.99	Professional	TC	$136.59	$188.52	$240.99