Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.26 / $160.30 / $347.83	Professional		$118.26	$160.30	$347.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $39.76 / $51.23 / $111.40	Professional	26	$39.76	$51.23	$111.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $321.88 / $321.88 / $321.88	Professional	50	$321.88	$321.88	$321.88
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $72.22 / $107.16 / $236.42	Professional	TC	$72.22	$107.16	$236.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $98.55 / $122.52 / $155.60	Professional		$98.55	$122.52	$155.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $31.10 / $37.97 / $48.23	Professional	26	$31.10	$37.97	$48.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $67.45 / $84.54 / $115.22	Professional	TC	$67.45	$84.54	$115.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.80 / $162.05 / $323.86	Professional		$108.80	$162.05	$323.86
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $55.73 / $104.37	Professional	26	$34.36	$55.73	$104.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $68.95 / $109.23 / $260.88	Professional	TC	$68.95	$109.23	$260.88
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $151.90 / $187.83 / $256.30	Professional		$151.90	$187.83	$256.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.25 / $50.70 / $75.98	Professional	26	$42.25	$50.70	$75.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.72 / $139.22 / $181.61	Professional	TC	$101.72	$139.22	$181.61
United Facility/Professional Professional Modifier Low / Median / High Price $88.92 / $119.32 / $208.75	Professional		$88.92	$119.32	$208.75
United Facility/Professional Professional Modifier 26 Low / Median / High Price $34.36 / $46.42 / $80.48	Professional	26	$34.36	$46.42	$80.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $54.12 / $71.61 / $134.05	Professional	TC	$54.12	$71.61	$134.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $178.70 / $232.49	Professional		$84.00	$178.70	$232.49
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $21.73 / $45.07 / $61.46	Professional	26	$21.73	$45.07	$61.46
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $62.27 / $133.79 / $171.03	Professional	TC	$62.27	$133.79	$171.03