Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.18 / $584.20 / $939.78	Facility		$129.18	$584.20	$939.78
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.44 / $28.37 / $46.66	Facility	26	$23.44	$28.37	$46.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.94 / $138.22 / $455.00	Professional		$99.94	$138.22	$455.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $24.07 / $36.96 / $124.36	Professional	26	$24.07	$36.96	$124.36
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $46.89 / $53.94 / $147.21	Professional	52	$46.89	$53.94	$147.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $75.84 / $94.75 / $262.08	Professional	TC	$75.84	$94.75	$262.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $120.93 / $134.37 / $206.55	Professional		$120.93	$134.37	$206.55
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $26.74 / $29.71 / $57.57	Professional	26	$26.74	$29.71	$57.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $94.19 / $104.66 / $139.44	Professional	TC	$94.19	$104.66	$139.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $101.67 / $101.67 / $101.67	Facility		$101.67	$101.67	$101.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $121.78 / $250.31	Professional		$87.03	$121.78	$250.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $20.62 / $31.18 / $59.44	Professional	26	$20.62	$31.18	$59.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.79 / $95.11 / $201.96	Professional	TC	$64.79	$95.11	$201.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $113.70 / $136.44 / $205.98	Professional		$113.70	$136.44	$205.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $26.96 / $32.64 / $47.04	Professional	26	$26.96	$32.64	$47.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $86.63 / $105.17 / $160.99	Professional	TC	$86.63	$105.17	$160.99
United Facility/Professional Facility Modifier Low / Median / High Price $20.13 / $47.92 / $190.19	Facility		$20.13	$47.92	$190.19
United Facility/Professional Professional Modifier Low / Median / High Price $83.28 / $118.01 / $257.42	Professional		$83.28	$118.01	$257.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $21.17 / $27.41 / $49.83	Professional	26	$21.17	$27.41	$49.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $61.85 / $89.14 / $185.50	Professional	TC	$61.85	$89.14	$185.50
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $93.42 / $130.76 / $161.47	Professional		$93.42	$130.76	$161.47
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $22.24 / $31.13 / $39.27	Professional	26	$22.24	$31.13	$39.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.18 / $99.62 / $124.29	Professional	TC	$71.18	$99.62	$124.29