Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $506.27 / $576.83 / $972.11	Facility		$506.27	$576.83	$972.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $82.01 / $142.85 / $368.92	Professional		$82.01	$142.85	$368.92
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $43.29 / $58.07 / $185.62	Professional	26	$43.29	$58.07	$185.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $38.72 / $76.00 / $185.38	Professional	TC	$38.72	$76.00	$185.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.39 / $150.88 / $198.25	Professional		$125.39	$150.88	$198.25
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $59.11 / $62.53 / $93.81	Professional	26	$59.11	$62.53	$93.81
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $43.74 / $88.35 / $110.44	Professional	TC	$43.74	$88.35	$110.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.25 / $86.43 / $229.26	Professional		$57.25	$86.43	$229.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.78 / $37.68 / $109.62	Professional	26	$0.78	$37.68	$109.62
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $1.20 / $49.09 / $119.64	Professional	TC	$1.20	$49.09	$119.64
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $177.07 / $211.28 / $265.61	Professional		$177.07	$211.28	$265.61
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.98 / $82.57 / $118.20	Professional	26	$67.98	$82.57	$118.20
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $109.09 / $130.91 / $163.63	Professional	TC	$109.09	$130.91	$163.63
United Facility/Professional Professional Modifier Low / Median / High Price $90.78 / $125.88 / $236.03	Professional		$90.78	$125.88	$236.03
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.85 / $59.18 / $110.97	Professional	26	$43.85	$59.18	$110.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $46.31 / $66.19 / $125.06	Professional	TC	$46.31	$66.19	$125.06
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $132.94 / $220.88 / $252.99	Professional		$132.94	$220.88	$252.99
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.62 / $82.57 / $99.27	Professional	26	$61.62	$82.57	$99.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.33 / $138.31 / $156.35	Professional	TC	$71.33	$138.31	$156.35