Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $74.45 / $102.02 / $392.23	Facility	26	$74.45	$102.02	$392.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $281.64 / $354.51 / $1,433.00	Professional		$281.64	$354.51	$1,433.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.16 / $97.64 / $317.79	Professional	26	$77.16	$97.64	$317.79
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $207.19 / $261.88 / $612.14	Professional	TC	$207.19	$261.88	$612.14
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $393.68 / $437.42 / $555.52	Professional		$393.68	$437.42	$555.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $96.80 / $96.80 / $125.84	Professional	26	$96.80	$96.80	$125.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $306.56 / $340.62 / $432.59	Professional	TC	$306.56	$340.62	$432.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.99 / $425.58 / $810.92	Professional		$252.99	$425.58	$810.92
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $67.52 / $103.15 / $199.45	Professional	26	$67.52	$103.15	$199.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $186.44 / $313.08 / $608.72	Professional	TC	$186.44	$313.08	$608.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $316.70 / $398.25 / $583.25	Professional		$316.70	$398.25	$583.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.96 / $105.17 / $189.77	Professional	26	$85.96	$105.17	$189.77
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $229.37 / $293.08 / $515.29	Professional	TC	$229.37	$293.08	$515.29
United Facility/Professional Professional Modifier Low / Median / High Price $192.50 / $360.26 / $633.88	Professional		$192.50	$360.26	$633.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.93 / $93.47 / $153.38	Professional	26	$48.93	$93.47	$153.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $156.59 / $274.76 / $582.79	Professional	TC	$156.59	$274.76	$582.79
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $254.34 / $346.30 / $450.19	Professional		$254.34	$346.30	$450.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $69.84 / $91.45 / $118.89	Professional	26	$69.84	$91.45	$118.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $184.51 / $254.85 / $325.80	Professional	TC	$184.51	$254.85	$325.80