Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $51.94 / $62.32 / $70.29	Facility	26	$51.94	$62.32	$70.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.02 / $303.77 / $1,095.00	Professional		$216.02	$303.77	$1,095.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $64.06 / $175.49	Professional	26	$53.83	$64.06	$175.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.85 / $237.18 / $783.18	Professional	TC	$158.85	$237.18	$783.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $276.45 / $307.16 / $390.09	Professional		$276.45	$307.16	$390.09
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $59.75 / $66.39 / $86.31	Professional	26	$59.75	$66.39	$86.31
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $216.70 / $240.78 / $305.79	Professional	TC	$216.70	$240.78	$305.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.34 / $347.13 / $654.53	Professional		$209.34	$347.13	$654.53
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $46.78 / $71.67 / $136.58	Professional	26	$46.78	$71.67	$136.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $159.91 / $284.45 / $495.13	Professional	TC	$159.91	$284.45	$495.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $243.00 / $313.47 / $497.03	Professional		$243.00	$313.47	$497.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $59.61 / $72.58 / $107.00	Professional	26	$59.61	$72.58	$107.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $182.52 / $235.45 / $372.33	Professional	TC	$182.52	$235.45	$372.33
United Facility/Professional Professional Modifier Low / Median / High Price $177.07 / $288.43 / $479.31	Professional		$177.07	$288.43	$479.31
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.22 / $65.31 / $110.41	Professional	26	$36.22	$65.31	$110.41
United Facility/Professional Professional Modifier TC Low / Median / High Price $148.68 / $204.74 / $395.19	Professional	TC	$148.68	$204.74	$395.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $194.40 / $265.06 / $344.58	Professional		$194.40	$265.06	$344.58
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $48.38 / $63.42 / $82.45	Professional	26	$48.38	$63.42	$82.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $146.02 / $201.64 / $257.77	Professional	TC	$146.02	$201.64	$257.77