Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $87.81 / $87.82 / $125.67	Facility	26	$87.81	$87.82	$125.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $293.74 / $332.01 / $803.46	Professional		$293.74	$332.01	$803.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.82 / $91.73 / $235.35	Professional	26	$87.82	$91.73	$235.35
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.15 / $240.27 / $581.45	Professional	TC	$204.15	$240.27	$581.45
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $380.28 / $380.28 / $499.69	Professional		$380.28	$380.28	$499.69
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $112.07 / $112.07 / $147.26	Professional	26	$112.07	$112.07	$147.26
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $268.20 / $268.20 / $352.43	Professional	TC	$268.20	$268.20	$352.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $280.80 / $423.36 / $952.30	Professional		$280.80	$423.36	$952.30
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.19 / $122.24 / $271.89	Professional	26	$81.19	$122.24	$271.89
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $199.50 / $299.77 / $678.95	Professional	TC	$199.50	$299.77	$678.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.02 / $468.30 / $791.70	Professional		$363.02	$468.30	$791.70
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $104.96 / $135.40 / $219.36	Professional	26	$104.96	$135.40	$219.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $258.06 / $332.90 / $569.79	Professional	TC	$258.06	$332.90	$569.79
United Facility/Professional Professional Modifier Low / Median / High Price $250.36 / $377.53 / $603.21	Professional		$250.36	$377.53	$603.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.62 / $108.55 / $181.53	Professional	26	$74.62	$108.55	$181.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $169.31 / $240.57 / $421.68	Professional	TC	$169.31	$240.57	$421.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $278.95 / $413.18 / $514.61	Professional		$278.95	$413.18	$514.61
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $80.65 / $120.70 / $144.25	Professional	26	$80.65	$120.70	$144.25
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $198.31 / $291.36 / $370.37	Professional	TC	$198.31	$291.36	$370.37