Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.72 / $61.37 / $100.93	Facility	26	$50.72	$61.37	$100.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.63 / $275.00 / $1,113.96	Professional		$180.63	$275.00	$1,113.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $66.59 / $247.37	Professional	26	$51.30	$66.59	$247.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $129.91 / $220.00 / $550.90	Professional	TC	$129.91	$220.00	$550.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $280.77 / $343.74 / $436.55	Professional		$280.77	$343.74	$436.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $65.93 / $71.54 / $90.86	Professional	26	$65.93	$71.54	$90.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $204.25 / $272.20 / $345.69	Professional	TC	$204.25	$272.20	$345.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.48 / $366.29 / $586.35	Professional		$175.48	$366.29	$586.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.00 / $76.22 / $141.86	Professional	26	$46.00	$76.22	$141.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $137.96 / $272.68 / $463.91	Professional	TC	$137.96	$272.68	$463.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $206.42 / $266.27 / $453.83	Professional		$206.42	$266.27	$453.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.62 / $71.50 / $115.82	Professional	26	$58.62	$71.50	$115.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $146.94 / $189.57 / $371.98	Professional	TC	$146.94	$189.57	$371.98
United Facility/Professional Professional Modifier Low / Median / High Price $183.13 / $280.64 / $502.41	Professional		$183.13	$280.64	$502.41
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.54 / $70.37 / $115.19	Professional	26	$34.54	$70.37	$115.19
United Facility/Professional Professional Modifier TC Low / Median / High Price $141.28 / $202.61 / $468.22	Professional	TC	$141.28	$202.61	$468.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.14 / $224.66 / $292.06	Professional		$165.14	$224.66	$292.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $47.58 / $62.36 / $81.06	Professional	26	$47.58	$62.36	$81.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $117.56 / $162.31 / $207.50	Professional	TC	$117.56	$162.31	$207.50