Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $60.65 / $65.23 / $100.59	Facility	26	$60.65	$65.23	$100.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $286.02 / $382.55 / $707.97	Professional		$286.02	$382.55	$707.97
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $50.55 / $57.71 / $141.63	Professional	26	$50.55	$57.71	$141.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $239.26 / $316.08 / $514.42	Professional	TC	$239.26	$316.08	$514.42
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $352.79 / $391.99 / $478.23	Professional		$352.79	$391.99	$478.23
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.65 / $54.05 / $90.80	Professional	26	$48.65	$54.05	$90.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $304.14 / $337.94 / $402.15	Professional	TC	$304.14	$337.94	$402.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.95 / $492.42 / $1,002.52	Professional		$236.95	$492.42	$1,002.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.78 / $77.94 / $142.32	Professional	26	$49.78	$77.94	$142.32
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $244.80 / $434.29 / $860.19	Professional	TC	$244.80	$434.29	$860.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.11 / $444.14 / $605.64	Professional		$288.11	$444.14	$605.64
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.12 / $61.78 / $84.24	Professional	26	$42.12	$61.78	$84.24
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $249.60 / $384.00 / $521.40	Professional	TC	$249.60	$384.00	$521.40
United Facility/Professional Professional Modifier Low / Median / High Price $191.22 / $357.86 / $712.11	Professional		$191.22	$357.86	$712.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.79 / $61.31 / $110.73	Professional	26	$43.79	$61.31	$110.73
United Facility/Professional Professional Modifier TC Low / Median / High Price $137.91 / $311.75 / $606.67	Professional	TC	$137.91	$311.75	$606.67
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $289.27 / $457.96 / $572.44	Professional		$289.27	$457.96	$572.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $40.24 / $64.58 / $81.54	Professional	26	$40.24	$64.58	$81.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $249.04 / $392.72 / $490.91	Professional	TC	$249.04	$392.72	$490.91