Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.20 / $125.89 / $151.36	Facility	26	$91.20	$125.89	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $478.63 / $1,584.89	Professional		$177.83	$478.63	$1,584.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $154.88 / $398.11	Professional	26	$79.43	$154.88	$398.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $354.81 / $741.31	Professional	TC	$251.19	$354.81	$741.31
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $416.87 / $501.19	Professional		$95.50	$416.87	$501.19
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $69.18 / $93.33 / $120.23	Professional	26	$69.18	$93.33	$120.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $363.08 / $467.74	Professional	TC	$323.59	$363.08	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $524.81 / $933.25	Professional		$281.84	$524.81	$933.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $91.20 / $173.78	Professional	26	$58.88	$91.20	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $398.11 / $758.58	Professional	TC	$218.78	$398.11	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $380.19 / $616.60	Professional		$331.13	$380.19	$616.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $85.11 / $117.49	Professional	26	$75.86	$85.11	$117.49
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $295.12 / $524.81	Professional	TC	$257.04	$295.12	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $446.68 / $776.25	Professional		$295.12	$446.68	$776.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.71 / $83.18 / $141.25	Professional	26	$45.71	$83.18	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $371.54 / $660.69	Professional	TC	$229.09	$371.54	$660.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $389.05 / $524.81	Professional		$331.13	$389.05	$524.81
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $77.62 / $89.13 / $117.49	Professional	26	$77.62	$89.13	$117.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $407.38	Professional	TC	$251.19	$295.12	$407.38