Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $75.01 / $126.00 / $152.46	Facility	26	$75.01	$126.00	$152.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $299.05 / $475.00 / $1,731.23	Professional		$299.05	$475.00	$1,731.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.06 / $126.00 / $331.00	Professional	26	$73.06	$126.00	$331.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $280.17 / $335.00 / $972.99	Professional	TC	$280.17	$335.00	$972.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $442.79 / $491.98 / $556.72	Professional		$442.79	$491.98	$556.72
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $64.53 / $73.76 / $84.30	Professional	26	$64.53	$73.76	$84.30
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $376.40 / $418.22 / $473.25	Professional	TC	$376.40	$418.22	$473.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $274.23 / $518.04 / $855.35	Professional		$274.23	$518.04	$855.35
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.90 / $76.44 / $149.31	Professional	26	$49.90	$76.44	$149.31
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.98 / $430.25 / $705.44	Professional	TC	$221.98	$430.25	$705.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $317.54 / $409.63 / $694.44	Professional		$317.54	$409.63	$694.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.64 / $77.09 / $105.06	Professional	26	$63.64	$77.09	$105.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $253.03 / $326.41 / $559.04	Professional	TC	$253.03	$326.41	$559.04
United Facility/Professional Professional Modifier Low / Median / High Price $235.73 / $412.13 / $740.86	Professional		$235.73	$412.13	$740.86
United Facility/Professional Professional Modifier 26 Low / Median / High Price $33.44 / $67.64 / $117.12	Professional	26	$33.44	$67.64	$117.12
United Facility/Professional Professional Modifier TC Low / Median / High Price $214.13 / $316.69 / $659.13	Professional	TC	$214.13	$316.69	$659.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.03 / $347.22 / $451.10	Professional		$254.03	$347.22	$451.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $51.62 / $67.70 / $88.01	Professional	26	$51.62	$67.70	$88.01
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $202.42 / $279.52 / $357.33	Professional	TC	$202.42	$279.52	$357.33