Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.84 / $88.61 / $100.51	Facility	26	$73.84	$88.61	$100.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $232.76 / $392.47 / $1,192.76	Professional		$232.76	$392.47	$1,192.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $73.84 / $91.27 / $251.68	Professional	26	$73.84	$91.27	$251.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $220.00 / $565.65	Professional	TC	$158.91	$220.00	$565.65
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $394.30 / $430.78 / $503.83	Professional		$394.30	$430.78	$503.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $77.00 / $99.37 / $113.58	Professional	26	$77.00	$99.37	$113.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $298.27 / $331.41 / $391.50	Professional	TC	$298.27	$331.41	$391.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $273.82 / $497.70 / $857.29	Professional		$273.82	$497.70	$857.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.98 / $101.66 / $198.71	Professional	26	$66.98	$101.66	$198.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $200.37 / $373.21 / $631.16	Professional	TC	$200.37	$373.21	$631.16
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $322.19 / $415.63 / $622.38	Professional		$322.19	$415.63	$622.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.24 / $101.73 / $141.00	Professional	26	$85.24	$101.73	$141.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $235.59 / $303.91 / $477.76	Professional	TC	$235.59	$303.91	$477.76
United Facility/Professional Professional Modifier Low / Median / High Price $242.42 / $389.92 / $770.59	Professional		$242.42	$389.92	$770.59
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.67 / $90.58 / $158.79	Professional	26	$37.67	$90.58	$158.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $192.48 / $295.02 / $575.54	Professional	TC	$192.48	$295.02	$575.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.82 / $302.73 / $393.55	Professional		$222.82	$302.73	$393.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.28 / $90.68 / $117.88	Professional	26	$69.28	$90.68	$117.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $153.54 / $212.05 / $271.08	Professional	TC	$153.54	$212.05	$271.08