Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.82 / $95.16 / $95.16	Facility	26	$47.82	$95.16	$95.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.33 / $330.02 / $400.67	Professional		$290.33	$330.02	$400.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.82 / $49.52 / $125.49	Professional	26	$47.82	$49.52	$125.49
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $242.52 / $280.99 / $334.68	Professional	TC	$242.52	$280.99	$334.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $399.16 / $399.16 / $459.03	Professional		$399.16	$399.16	$459.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $61.47 / $61.47 / $70.69	Professional	26	$61.47	$61.47	$70.69
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $337.69 / $337.69 / $388.34	Professional	TC	$337.69	$337.69	$388.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.85 / $416.53 / $878.32	Professional		$252.85	$416.53	$878.32
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.01 / $63.12 / $146.69	Professional	26	$43.01	$63.12	$146.69
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $209.80 / $353.41 / $731.61	Professional	TC	$209.80	$353.41	$731.61
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.30 / $386.53 / $715.80	Professional		$309.30	$386.53	$715.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $52.88 / $64.17 / $114.75	Professional	26	$52.88	$64.17	$114.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $255.30 / $323.52 / $599.12	Professional	TC	$255.30	$323.52	$599.12
United Facility/Professional Professional Modifier Low / Median / High Price $286.32 / $387.50 / $926.35	Professional		$286.32	$387.50	$926.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.38 / $54.42 / $102.16	Professional	26	$43.38	$54.42	$102.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $236.30 / $311.13 / $542.80	Professional	TC	$236.30	$311.13	$542.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $261.51 / $313.39 / $463.95	Professional		$261.51	$313.39	$463.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $44.53 / $53.37 / $75.84	Professional	26	$44.53	$53.37	$75.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $216.99 / $260.06 / $382.95	Professional	TC	$216.99	$260.06	$382.95