Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.79 / $68.14 / $76.98	Facility	26	$56.79	$68.14	$76.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $221.68 / $366.58 / $1,116.46	Professional		$221.68	$366.58	$1,116.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.79 / $72.87 / $191.61	Professional	26	$56.79	$72.87	$191.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $159.15 / $234.80 / $930.84	Professional	TC	$159.15	$234.80	$930.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $338.95 / $369.22 / $468.91	Professional		$338.95	$369.22	$468.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $67.00 / $73.45 / $94.00	Professional	26	$67.00	$73.45	$94.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $266.19 / $295.77 / $375.63	Professional	TC	$266.19	$295.77	$375.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $235.38 / $425.63 / $735.58	Professional		$235.38	$425.63	$735.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.18 / $78.39 / $149.88	Professional	26	$51.18	$78.39	$149.88
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $181.82 / $338.85 / $561.21	Professional	TC	$181.82	$338.85	$561.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $273.08 / $352.29 / $563.99	Professional		$273.08	$352.29	$563.99
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $65.25 / $79.40 / $117.59	Professional	26	$65.25	$79.40	$117.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $206.93 / $266.94 / $426.91	Professional	TC	$206.93	$266.94	$426.91
United Facility/Professional Professional Modifier Low / Median / High Price $226.64 / $325.38 / $624.25	Professional		$226.64	$325.38	$624.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $35.08 / $71.51 / $123.02	Professional	26	$35.08	$71.51	$123.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $171.35 / $262.13 / $553.48	Professional	TC	$171.35	$262.13	$553.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $206.48 / $281.45 / $365.90	Professional		$206.48	$281.45	$365.90
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.94 / $69.41 / $90.23	Professional	26	$52.94	$69.41	$90.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.54 / $212.05 / $271.08	Professional	TC	$153.54	$212.05	$271.08