Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $49.58 / $98.66 / $98.66	Facility	26	$49.58	$98.66	$98.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.72 / $247.53 / $952.69	Professional		$154.72	$247.53	$952.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.30 / $61.24 / $165.88	Professional	26	$51.30	$61.24	$165.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $105.15 / $165.56 / $550.82	Professional	TC	$105.15	$165.56	$550.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $240.47 / $282.80 / $320.01	Professional		$240.47	$282.80	$320.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.28 / $63.79 / $74.78	Professional	26	$58.28	$63.79	$74.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $165.68 / $219.01 / $247.83	Professional	TC	$165.68	$219.01	$247.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $150.29 / $306.43 / $490.35	Professional		$150.29	$306.43	$490.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $67.62 / $133.74	Professional	26	$44.64	$67.62	$133.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $103.55 / $224.94 / $382.62	Professional	TC	$103.55	$224.94	$382.62
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.11 / $228.47 / $384.84	Professional		$177.11	$228.47	$384.84
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $56.94 / $69.25 / $102.30	Professional	26	$56.94	$69.25	$102.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $119.40 / $154.03 / $298.74	Professional	TC	$119.40	$154.03	$298.74
United Facility/Professional Professional Modifier Low / Median / High Price $158.79 / $236.32 / $445.75	Professional		$158.79	$236.32	$445.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.58 / $62.44 / $115.74	Professional	26	$34.58	$62.44	$115.74
United Facility/Professional Professional Modifier TC Low / Median / High Price $111.14 / $163.96 / $361.53	Professional	TC	$111.14	$163.96	$361.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $141.69 / $192.42 / $250.15	Professional		$141.69	$192.42	$250.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.17 / $60.57 / $78.73	Professional	26	$46.17	$60.57	$78.73
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $95.52 / $131.85 / $168.56	Professional	TC	$95.52	$131.85	$168.56