Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $56.23 / $69.18 / $69.18	Facility	26	$56.23	$69.18	$69.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $398.11 / $1,380.38	Professional		$234.42	$398.11	$1,380.38
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $107.15 / $213.80	Professional	26	$61.66	$107.15	$213.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $275.42 / $977.24	Professional	TC	$169.82	$275.42	$977.24
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $338.84 / $489.78	Professional		$77.62	$338.84	$489.78
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $87.10 / $117.49	Professional	26	$72.44	$87.10	$117.49
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $288.40 / $389.05	Professional	TC	$257.04	$288.40	$389.05
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $107.15 / $107.15 / $107.15	Facility	26	$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $380.19 / $741.31	Professional		$229.09	$380.19	$741.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $141.25	Professional	26	$51.29	$77.62	$141.25
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $177.83 / $295.12 / $562.34	Professional	TC	$177.83	$295.12	$562.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $316.23 / $478.63	Professional		$269.15	$316.23	$478.63
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $72.44 / $100.00	Professional	26	$64.57	$72.44	$100.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $239.88 / $398.11	Professional	TC	$208.93	$239.88	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $602.56	Professional		$223.87	$338.84	$602.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $39.81 / $72.44 / $123.03	Professional	26	$39.81	$72.44	$123.03
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.82 / $263.03 / $489.78	Professional	TC	$169.82	$263.03	$489.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.04 / $295.12 / $398.11	Professional		$257.04	$295.12	$398.11
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $75.86 / $100.00	Professional	26	$66.07	$75.86	$100.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $223.87 / $295.12	Professional	TC	$190.55	$223.87	$295.12