Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $177.83 / $181.97	Facility	26	$131.83	$177.83	$181.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $371.54 / $977.24	Professional		$234.42	$371.54	$977.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $251.19 / $549.54	Professional	26	$128.82	$251.19	$549.54
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $154.88 / $331.13	Professional	TC	$109.65	$154.88	$331.13
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $323.59 / $436.52	Professional		$190.55	$323.59	$436.52
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $147.91 / $165.96 / $169.82	Professional	26	$147.91	$165.96	$169.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $158.49 / $204.17	Professional	TC	$144.54	$158.49	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $229.09 / $316.23 / $776.25	Professional		$229.09	$316.23	$776.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $181.97 / $407.38	Professional	26	$120.23	$181.97	$407.38
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $109.65 / $169.82 / $380.19	Professional	TC	$109.65	$169.82	$380.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $338.84 / $512.86	Professional		$295.12	$338.84	$512.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $154.88 / $173.78 / $257.04	Professional	26	$154.88	$173.78	$257.04
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $141.25 / $165.96 / $257.04	Professional	TC	$141.25	$165.96	$257.04
United Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $295.12 / $524.81	Professional		$213.80	$295.12	$524.81
United Facility/Professional Professional Modifier 26 Low / Median / High Price $109.65 / $158.49 / $275.42	Professional	26	$109.65	$158.49	$275.42
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.71 / $141.25 / $251.19	Professional	TC	$104.71	$141.25	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $354.81 / $457.09	Professional		$239.88	$354.81	$457.09
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $125.89 / $181.97 / $234.42	Professional	26	$125.89	$181.97	$234.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $169.82 / $223.87	Professional	TC	$114.82	$169.82	$223.87