Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.47 / $63.57 / $70.55	Facility	26	$50.47	$63.57	$70.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $246.94 / $294.64 / $1,182.00	Professional		$246.94	$294.64	$1,182.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.50 / $99.87 / $369.00	Professional	26	$51.50	$99.87	$369.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.34 / $219.11 / $538.94	Professional	TC	$162.34	$219.11	$538.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $258.58 / $270.14 / $588.86	Professional		$258.58	$270.14	$588.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $58.99 / $65.73 / $211.29	Professional	26	$58.99	$65.73	$211.29
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $163.22 / $204.41 / $415.59	Professional	TC	$163.22	$204.41	$415.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.32 / $401.62 / $603.25	Professional		$256.32	$401.62	$603.25
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.51 / $88.85 / $156.35	Professional	26	$52.51	$88.85	$156.35
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $202.83 / $313.86 / $487.83	Professional	TC	$202.83	$313.86	$487.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $271.05 / $349.65 / $504.25	Professional		$271.05	$349.65	$504.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $54.91 / $70.83 / $113.02	Professional	26	$54.91	$70.83	$113.02
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $216.14 / $278.82 / $411.71	Professional	TC	$216.14	$278.82	$411.71
United Facility/Professional Professional Modifier Low / Median / High Price $245.95 / $358.69 / $673.25	Professional		$245.95	$358.69	$673.25
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.63 / $78.36 / $130.38	Professional	26	$51.63	$78.36	$130.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.28 / $289.93 / $573.54	Professional	TC	$191.28	$289.93	$573.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $224.54 / $311.70 / $384.76	Professional		$224.54	$311.70	$384.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $45.49 / $63.15 / $79.47	Professional	26	$45.49	$63.15	$79.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.05 / $248.56 / $310.23	Professional	TC	$179.05	$248.56	$310.23