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 $213.32 / $475.00 / $1,234.34	Professional		$213.32	$475.00	$1,234.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.22 / $140.00 / $271.00	Professional	26	$71.22	$140.00	$271.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $117.18 / $212.50 / $588.79	Professional	52	$117.18	$212.50	$588.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $155.06 / $335.00 / $801.32	Professional	TC	$155.06	$335.00	$801.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $285.37 / $317.08 / $506.77	Professional		$285.37	$317.08	$506.77
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $71.17 / $80.66 / $105.98	Professional	26	$71.17	$80.66	$105.98
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $212.78 / $236.43 / $435.60	Professional	TC	$212.78	$236.43	$435.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $170.53 / $377.69 / $725.33	Professional		$170.53	$377.69	$725.33
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.63 / $84.02 / $163.40	Professional	26	$54.63	$84.02	$163.40
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $113.37 / $276.81 / $597.96	Professional	TC	$113.37	$276.81	$597.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $200.84 / $259.08 / $491.69	Professional		$200.84	$259.08	$491.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.63 / $84.74 / $125.22	Professional	26	$69.63	$84.74	$125.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $130.21 / $167.97 / $371.64	Professional	TC	$130.21	$167.97	$371.64
United Facility/Professional Professional Modifier Low / Median / High Price $189.03 / $267.45 / $671.96	Professional		$189.03	$267.45	$671.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.99 / $71.47 / $119.47	Professional	26	$36.99	$71.47	$119.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $123.71 / $191.77 / $473.34	Professional	TC	$123.71	$191.77	$473.34
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $160.66 / $217.87 / $283.23	Professional		$160.66	$217.87	$283.23
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 $104.17 / $143.80 / $183.84	Professional	TC	$104.17	$143.80	$183.84