Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $96.78 / $96.78 / $137.47	Facility	26	$96.78	$96.78	$137.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $255.69 / $347.21 / $813.54	Professional		$255.69	$347.21	$813.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $96.78 / $116.06 / $523.97	Professional	26	$96.78	$116.06	$523.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.91 / $231.31 / $425.90	Professional	TC	$158.91	$231.31	$425.90
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $388.56 / $388.56 / $497.36	Professional		$388.56	$388.56	$497.36
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $119.61 / $119.61 / $153.10	Professional	26	$119.61	$119.61	$153.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $268.94 / $268.94 / $344.24	Professional	TC	$268.94	$268.94	$344.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.44 / $557.48 / $899.79	Professional		$282.44	$557.48	$899.79
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.05 / $131.34 / $261.33	Professional	26	$87.05	$131.34	$261.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $192.50 / $396.09 / $645.96	Professional	TC	$192.50	$396.09	$645.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $339.81 / $407.77 / $696.48	Professional		$339.81	$407.77	$696.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $132.10 / $185.10	Professional	26	$112.20	$132.10	$185.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $225.90 / $278.45 / $498.86	Professional	TC	$225.90	$278.45	$498.86
United Facility/Professional Professional Modifier Low / Median / High Price $295.04 / $419.29 / $720.40	Professional		$295.04	$419.29	$720.40
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.16 / $120.90 / $223.61	Professional	26	$60.16	$120.90	$223.61
United Facility/Professional Professional Modifier TC Low / Median / High Price $209.18 / $308.55 / $754.22	Professional	TC	$209.18	$308.55	$754.22
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $271.85 / $368.80 / $479.44	Professional		$271.85	$368.80	$479.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $91.12 / $119.36 / $155.16	Professional	26	$91.12	$119.36	$155.16
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $180.72 / $249.43 / $318.86	Professional	TC	$180.72	$249.43	$318.86