Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $91.99 / $92.75 / $98.62	Facility	26	$91.99	$92.75	$98.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.94 / $426.60 / $767.29	Professional		$346.94	$426.60	$767.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $77.03 / $90.76 / $209.15	Professional	26	$77.03	$90.76	$209.15
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $265.87 / $336.82 / $576.57	Professional	TC	$265.87	$336.82	$576.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $438.58 / $487.32 / $579.91	Professional		$438.58	$487.32	$579.91
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $77.31 / $85.91 / $107.39	Professional	26	$77.31	$85.91	$107.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $361.27 / $401.41 / $477.68	Professional	TC	$361.27	$401.41	$477.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.99 / $584.25 / $1,122.72	Professional		$337.99	$584.25	$1,122.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $75.28 / $119.69 / $217.24	Professional	26	$75.28	$119.69	$217.24
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $275.75 / $473.65 / $905.48	Professional	TC	$275.75	$473.65	$905.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $345.23 / $507.22 / $691.67	Professional		$345.23	$507.22	$691.67
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.68 / $93.40 / $127.37	Professional	26	$63.68	$93.40	$127.37
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $270.14 / $415.61 / $564.29	Professional	TC	$270.14	$415.61	$564.29
United Facility/Professional Professional Modifier Low / Median / High Price $254.24 / $415.95 / $797.23	Professional		$254.24	$415.95	$797.23
United Facility/Professional Professional Modifier 26 Low / Median / High Price $69.63 / $94.53 / $166.56	Professional	26	$69.63	$94.53	$166.56
United Facility/Professional Professional Modifier TC Low / Median / High Price $159.99 / $319.45 / $611.99	Professional	TC	$159.99	$319.45	$611.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $325.97 / $523.69 / $654.62	Professional		$325.97	$523.69	$654.62
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.01 / $97.65 / $123.29	Professional	26	$60.01	$97.65	$123.29
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $265.93 / $425.06 / $531.33	Professional	TC	$265.93	$425.06	$531.33