Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $72.95 / $72.97 / $99.32	Facility	26	$72.95	$72.97	$99.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $231.89 / $323.08 / $1,146.96	Professional		$231.89	$323.08	$1,146.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $72.97 / $83.24 / $241.23	Professional	26	$72.97	$83.24	$241.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $219.31 / $638.90	Professional	TC	$158.91	$219.31	$638.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $373.12 / $428.82 / $501.70	Professional		$373.12	$428.82	$501.70
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $94.93 / $109.66	Professional	26	$77.00	$94.93	$109.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $296.12 / $333.89 / $383.97	Professional	TC	$296.12	$333.89	$383.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $272.66 / $480.80 / $853.67	Professional		$272.66	$480.80	$853.67
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.19 / $100.33 / $194.38	Professional	26	$66.19	$100.33	$194.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.66 / $372.14 / $630.25	Professional	TC	$200.66	$372.14	$630.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $320.82 / $413.86 / $622.38	Professional		$320.82	$413.86	$622.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.20 / $101.73 / $139.85	Professional	26	$84.20	$101.73	$139.85
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $235.24 / $303.45 / $477.01	Professional	TC	$235.24	$303.45	$477.01
United Facility/Professional Professional Modifier Low / Median / High Price $255.07 / $418.22 / $830.04	Professional		$255.07	$418.22	$830.04
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.54 / $86.75 / $149.65	Professional	26	$45.54	$86.75	$149.65
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.78 / $284.45 / $528.08	Professional	TC	$192.78	$284.45	$528.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.00 / $301.62 / $392.11	Professional		$222.00	$301.62	$392.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $89.57 / $116.44	Professional	26	$68.45	$89.57	$116.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.54 / $212.05 / $271.08	Professional	TC	$153.54	$212.05	$271.08