Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.29 / $64.01 / $94.12	Facility	26	$47.29	$64.01	$94.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.15 / $284.45 / $1,127.00	Professional		$206.15	$284.45	$1,127.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.03 / $60.31 / $208.59	Professional	26	$49.03	$60.31	$208.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.85 / $217.46 / $428.80	Professional	TC	$158.85	$217.46	$428.80
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $245.06 / $266.92 / $338.99	Professional		$245.06	$266.92	$338.99
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $54.75 / $60.83 / $79.08	Professional	26	$54.75	$60.83	$79.08
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $196.24 / $206.09 / $261.73	Professional	TC	$196.24	$206.09	$261.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $205.84 / $337.70 / $642.95	Professional		$205.84	$337.70	$642.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.57 / $65.22 / $124.11	Professional	26	$42.57	$65.22	$124.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $160.49 / $273.36 / $486.66	Professional	TC	$160.49	$273.36	$486.66
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $238.95 / $308.25 / $488.29	Professional		$238.95	$308.25	$488.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.28 / $66.04 / $97.59	Professional	26	$54.28	$66.04	$97.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $183.91 / $237.24 / $373.85	Professional	TC	$183.91	$237.24	$373.85
United Facility/Professional Professional Modifier Low / Median / High Price $170.56 / $270.33 / $424.01	Professional		$170.56	$270.33	$424.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.04 / $62.30 / $163.16	Professional	26	$34.04	$62.30	$163.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $132.84 / $204.38 / $352.99	Professional	TC	$132.84	$204.38	$352.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $191.16 / $260.92 / $339.20	Professional		$191.16	$260.92	$339.20
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.02 / $57.74 / $75.06	Professional	26	$44.02	$57.74	$75.06
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $147.13 / $203.18 / $259.76	Professional	TC	$147.13	$203.18	$259.76