Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $97.72 / $1,318.26	Facility		$61.66	$97.72	$1,318.26
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $25.70 / $31.62 / $38.02	Facility	26	$25.70	$31.62	$38.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $93.33 / $501.19	Professional		$51.29	$93.33	$501.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.92 / $48.98 / $147.91	Professional	26	$26.92	$48.98	$147.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $38.02 / $181.97	Professional	TC	$21.88	$38.02	$181.97
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $58.88 / $194.98	Professional		$33.88	$58.88	$194.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $31.62 / $42.66	Professional	26	$28.18	$31.62	$42.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $28.18 / $30.20 / $162.18	Professional	TC	$28.18	$30.20	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $93.33 / $114.82	Facility		$93.33	$93.33	$114.82
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $48.98 / $48.98 / $48.98	Facility	26	$48.98	$48.98	$48.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $95.50 / $229.09	Professional		$45.71	$95.50	$229.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $36.31 / $67.61	Professional	26	$22.91	$36.31	$67.61
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $47.86 / $186.21	Professional	TC	$22.39	$47.86	$186.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $79.43 / $141.25	Professional		$67.61	$79.43	$141.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $37.15 / $50.12	Professional	26	$32.36	$37.15	$50.12
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $35.48 / $41.69 / $77.62	Professional	TC	$35.48	$41.69	$77.62
United Facility/Professional Facility Modifier Low / Median / High Price $24.55 / $48.98 / $95.50	Facility		$24.55	$48.98	$95.50
United Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $95.50 / $223.87	Professional		$50.12	$95.50	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $25.12 / $32.36 / $58.88	Professional	26	$25.12	$32.36	$58.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $22.91 / $45.71 / $186.21	Professional	TC	$22.91	$45.71	$186.21
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $83.18 / $97.72	Professional		$58.88	$83.18	$97.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $29.51 / $39.81 / $45.71	Professional	26	$29.51	$39.81	$45.71
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $29.51 / $44.67 / $50.12	Professional	TC	$29.51	$44.67	$50.12