Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.98 / $72.23 / $192.78	Facility		$0.98	$72.23	$192.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.83 / $70.83 / $99.43	Facility	26	$70.83	$70.83	$99.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $132.71 / $183.92 / $468.55	Professional		$132.71	$183.92	$468.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.67 / $72.58 / $175.64	Professional	26	$50.67	$72.58	$175.64
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $65.23 / $70.36 / $464.91	Professional	52	$65.23	$70.36	$464.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $61.88 / $117.57 / $377.50	Professional	TC	$61.88	$117.57	$377.50
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $174.52 / $181.82 / $607.16	Professional		$174.52	$181.82	$607.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.12 / $75.03 / $95.29	Professional	26	$58.12	$75.03	$95.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $98.54 / $106.79 / $545.22	Professional	TC	$98.54	$106.79	$545.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $670.17 / $670.17 / $670.17	Facility		$670.17	$670.17	$670.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $119.92 / $216.58 / $567.64	Professional		$119.92	$216.58	$567.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.24 / $78.51 / $177.71	Professional	26	$53.24	$78.51	$177.71
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $54.60 / $115.84 / $347.23	Professional	TC	$54.60	$115.84	$347.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $153.33 / $197.80 / $326.74	Professional		$153.33	$197.80	$326.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.59 / $95.15 / $135.22	Professional	26	$64.59	$95.15	$135.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $70.59 / $91.06 / $192.64	Professional	TC	$70.59	$91.06	$192.64
United Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $227.36 / $439.13	Professional		$144.28	$227.36	$439.13
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.18 / $78.04 / $149.56	Professional	26	$45.18	$78.04	$149.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $68.98 / $115.30 / $318.89	Professional	TC	$68.98	$115.30	$318.89
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $122.66 / $163.37 / $218.04	Professional		$122.66	$163.37	$218.04
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.19 / $86.90 / $118.50	Professional	26	$66.19	$86.90	$118.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $56.47 / $77.87 / $99.54	Professional	TC	$56.47	$77.87	$99.54