Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $80.50 / $126.00 / $250.74	Facility	26	$80.50	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.82 / $475.00 / $1,269.16	Professional		$240.82	$475.00	$1,269.16
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $71.37 / $126.00 / $322.00	Professional	26	$71.37	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $178.38 / $335.00 / $865.83	Professional	TC	$178.38	$335.00	$865.83
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $335.47 / $341.52 / $465.92	Professional		$335.47	$341.52	$465.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $69.80 / $79.08 / $100.43	Professional	26	$69.80	$79.08	$100.43
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $253.28 / $262.44 / $389.92	Professional	TC	$253.28	$262.44	$389.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $174.76 / $429.27 / $699.07	Professional		$174.76	$429.27	$699.07
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.58 / $82.44 / $160.32	Professional	26	$53.58	$82.44	$160.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $118.73 / $303.74 / $555.22	Professional	TC	$118.73	$303.74	$555.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $205.41 / $264.98 / $492.14	Professional		$205.41	$264.98	$492.14
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $68.25 / $83.12 / $112.73	Professional	26	$68.25	$83.12	$112.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $136.13 / $175.62 / $371.64	Professional	TC	$136.13	$175.62	$371.64
United Facility/Professional Professional Modifier Low / Median / High Price $189.34 / $274.13 / $609.16	Professional		$189.34	$274.13	$609.16
United Facility/Professional Professional Modifier 26 Low / Median / High Price $36.49 / $80.78 / $171.52	Professional	26	$36.49	$80.78	$171.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $131.41 / $202.10 / $495.70	Professional	TC	$131.41	$202.10	$495.70
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $164.33 / $222.97 / $289.86	Professional		$164.33	$222.97	$289.86
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.42 / $72.61 / $94.39	Professional	26	$55.42	$72.61	$94.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $108.91 / $150.36 / $192.21	Professional	TC	$108.91	$150.36	$192.21