Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $88.60 / $88.60 / $95.08	Facility	26	$88.60	$88.60	$95.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $216.97 / $271.20 / $1,104.11	Professional		$216.97	$271.20	$1,104.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.79 / $95.99 / $326.00	Professional	26	$75.79	$95.99	$326.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $143.13 / $170.00 / $383.58	Professional	TC	$143.13	$170.00	$383.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $241.40 / $250.44 / $400.58	Professional		$241.40	$250.44	$400.58
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.52 / $95.02 / $121.63	Professional	26	$85.52	$95.02	$121.63
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $153.77 / $155.41 / $198.94	Professional	TC	$153.77	$155.41	$198.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $228.44 / $343.65 / $705.34	Professional		$228.44	$343.65	$705.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $80.75 / $118.06 / $213.90	Professional	26	$80.75	$118.06	$213.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.21 / $218.28 / $487.10	Professional	TC	$154.21	$218.28	$487.10
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $237.29 / $301.36 / $450.27	Professional		$237.29	$301.36	$450.27
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.34 / $103.47 / $136.87	Professional	26	$81.34	$103.47	$136.87
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $155.82 / $197.89 / $314.73	Professional	TC	$155.82	$197.89	$314.73
United Facility/Professional Professional Modifier Low / Median / High Price $206.31 / $292.41 / $521.19	Professional		$206.31	$292.41	$521.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $70.80 / $99.99 / $170.55	Professional	26	$70.80	$99.99	$170.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $129.90 / $170.80 / $315.74	Professional	TC	$129.90	$170.80	$315.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $215.33 / $272.88 / $338.63	Professional		$215.33	$272.88	$338.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $73.92 / $93.69 / $118.86	Professional	26	$73.92	$93.69	$118.86
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $141.41 / $179.19 / $223.51	Professional	TC	$141.41	$179.19	$223.51