Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.87 / $179.35 / $260.45	Facility	26	$130.87	$179.35	$260.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.77 / $268.70 / $672.06	Professional		$250.77	$268.70	$672.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $130.88 / $136.72 / $308.36	Professional	26	$130.88	$136.72	$308.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $119.89 / $131.99 / $319.41	Professional	TC	$119.89	$131.99	$319.41
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $323.26 / $323.26 / $491.80	Professional		$323.26	$323.26	$491.80
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $160.66 / $161.44 / $212.15	Professional	26	$160.66	$161.44	$212.15
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $161.81 / $161.81 / $222.45	Professional	TC	$161.81	$161.81	$222.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.05 / $348.82 / $780.03	Professional		$233.05	$348.82	$780.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $121.15 / $181.56 / $403.84	Professional	26	$121.15	$181.56	$403.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $111.89 / $166.04 / $376.20	Professional	TC	$111.89	$166.04	$376.20
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $301.29 / $388.66 / $649.91	Professional		$301.29	$388.66	$649.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $156.63 / $202.05 / $328.18	Professional	26	$156.63	$202.05	$328.18
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $144.66 / $186.61 / $319.20	Professional	TC	$144.66	$186.61	$319.20
United Facility/Professional Professional Modifier Low / Median / High Price $215.02 / $295.93 / $515.78	Professional		$215.02	$295.93	$515.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.04 / $157.35 / $257.99	Professional	26	$110.04	$157.35	$257.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $107.23 / $162.10 / $361.68	Professional	TC	$107.23	$162.10	$361.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.45 / $344.74 / $422.45	Professional		$239.45	$344.74	$422.45
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $124.49 / $180.12 / $214.98	Professional	26	$124.49	$180.12	$214.98
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $114.96 / $163.19 / $207.48	Professional	TC	$114.96	$163.19	$207.48