Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.15 / $100.90 / $147.55	Facility	26	$74.15	$100.90	$147.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.06 / $386.10 / $1,220.05	Professional		$233.06	$386.10	$1,220.05
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $76.83 / $96.89 / $345.77	Professional	26	$76.83	$96.89	$345.77
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $291.01 / $941.08	Professional	TC	$158.91	$291.01	$941.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $378.45 / $420.50 / $569.04	Professional		$378.45	$420.50	$569.04
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.41 / $100.11 / $114.43	Professional	26	$87.41	$100.11	$114.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $288.35 / $320.39 / $481.64	Professional	TC	$288.35	$320.39	$481.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.50 / $464.24 / $788.45	Professional		$251.50	$464.24	$788.45
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.25 / $102.68 / $199.45	Professional	26	$67.25	$102.68	$199.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.81 / $340.20 / $609.47	Professional	TC	$181.81	$340.20	$609.47
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $297.08 / $383.25 / $626.60	Professional		$297.08	$383.25	$626.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.61 / $101.73 / $141.61	Professional	26	$85.61	$101.73	$141.61
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $210.14 / $271.08 / $448.18	Professional	TC	$210.14	$271.08	$448.18
United Facility/Professional Professional Modifier Low / Median / High Price $215.98 / $364.80 / $678.79	Professional		$215.98	$364.80	$678.79
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.63 / $93.43 / $172.61	Professional	26	$54.63	$93.43	$172.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $180.61 / $282.35 / $597.15	Professional	TC	$180.61	$282.35	$597.15
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $223.44 / $303.49 / $394.54	Professional		$223.44	$303.49	$394.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.56 / $91.07 / $118.39	Professional	26	$69.56	$91.07	$118.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.88 / $212.43 / $271.56	Professional	TC	$153.88	$212.43	$271.56