Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.48 / $63.10 / $70.79	Facility	26	$52.48	$63.10	$70.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $1,258.93	Professional		$234.42	$371.54	$1,258.93
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $107.15 / $218.78	Professional	26	$57.54	$107.15	$218.78
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.18 / $239.88 / $588.84	Professional	TC	$162.18	$239.88	$588.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $323.59 / $446.68	Professional		$239.88	$323.59	$446.68
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $89.13	Professional	26	$66.07	$77.62	$89.13
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $257.04 / $288.40	Professional	TC	$229.09	$257.04	$288.40
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.72 / $97.72 / $97.72	Facility	26	$97.72	$97.72	$97.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $331.13 / $645.65	Professional		$204.17	$331.13	$645.65
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.77 / $70.79 / $128.82	Professional	26	$46.77	$70.79	$128.82
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $151.36 / $251.19 / $489.78	Professional	TC	$151.36	$251.19	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $281.84 / $398.11	Professional		$239.88	$281.84	$398.11
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $66.07 / $91.20	Professional	26	$58.88	$66.07	$91.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $181.97 / $213.80 / $323.59	Professional	TC	$181.97	$213.80	$323.59
United Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $302.00 / $478.63	Professional		$190.55	$302.00	$478.63
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.31 / $64.57 / $112.20	Professional	26	$36.31	$64.57	$112.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $229.09 / $398.11	Professional	TC	$147.91	$229.09	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $281.84 / $389.05	Professional		$229.09	$281.84	$389.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $56.23 / $69.18 / $91.20	Professional	26	$56.23	$69.18	$91.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $213.80 / $295.12	Professional	TC	$169.82	$213.80	$295.12