Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.86 / $125.89 / $151.36	Facility	26	$75.86	$125.89	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $467.74 / $1,905.46	Professional		$134.90	$467.74	$1,905.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $134.90 / $331.13	Professional	26	$69.18	$134.90	$331.13
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $338.84 / $870.96	Professional	TC	$239.88	$338.84	$870.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $426.58 / $489.78	Professional		$97.72	$426.58	$489.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $85.11 / $91.20	Professional	26	$74.13	$85.11	$91.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $363.08 / $416.87	Professional	TC	$323.59	$363.08	$416.87
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $104.71 / $104.71 / $104.71	Facility	26	$104.71	$104.71	$104.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $501.19 / $912.01	Professional		$275.42	$501.19	$912.01
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.12 / $74.13 / $144.54	Professional	26	$50.12	$74.13	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $398.11 / $724.44	Professional	TC	$218.78	$398.11	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $489.78	Professional		$316.23	$371.54	$489.78
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $72.44 / $97.72	Professional	26	$63.10	$72.44	$97.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $407.38	Professional	TC	$257.04	$295.12	$407.38
United Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $426.58 / $741.31	Professional		$281.84	$426.58	$741.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $69.18 / $117.49	Professional	26	$38.02	$69.18	$117.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $354.81 / $645.65	Professional	TC	$229.09	$354.81	$645.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $478.63	Professional		$316.23	$371.54	$478.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $75.86 / $97.72	Professional	26	$64.57	$75.86	$97.72
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $389.05	Professional	TC	$251.19	$295.12	$389.05