Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $82.07 / $126.00 / $250.74	Facility	26	$82.07	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $209.68 / $475.00 / $1,193.30	Professional		$209.68	$475.00	$1,193.30
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.47 / $140.00 / $341.37	Professional	26	$71.47	$140.00	$341.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $154.25 / $335.00 / $812.95	Professional	TC	$154.25	$335.00	$812.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $284.75 / $312.82 / $511.72	Professional		$284.75	$312.82	$511.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $75.43 / $80.23 / $97.09	Professional	26	$75.43	$80.23	$97.09
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $209.32 / $232.58 / $434.94	Professional	TC	$209.32	$232.58	$434.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.64 / $377.53 / $718.67	Professional		$169.64	$377.53	$718.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.63 / $88.48 / $162.66	Professional	26	$54.63	$88.48	$162.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.77 / $277.45 / $597.96	Professional	TC	$112.77	$277.45	$597.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.49 / $258.63 / $490.87	Professional		$200.49	$258.63	$490.87
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.63 / $84.74 / $134.63	Professional	26	$69.63	$84.74	$134.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $129.86 / $167.52 / $371.64	Professional	TC	$129.86	$167.52	$371.64
United Facility/Professional Professional Modifier Low / Median / High Price $190.76 / $286.66 / $598.99	Professional		$190.76	$286.66	$598.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.90 / $73.09 / $124.87	Professional	26	$37.90	$73.09	$124.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $126.52 / $191.92 / $471.69	Professional	TC	$126.52	$191.92	$471.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.38 / $217.48 / $282.72	Professional		$160.38	$217.48	$282.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $56.50 / $74.06 / $96.29	Professional	26	$56.50	$74.06	$96.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $103.89 / $143.41 / $183.35	Professional	TC	$103.89	$143.41	$183.35