Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $50.54 / $63.18 / $65.23	Facility	26	$50.54	$63.18	$65.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $328.32 / $451.00 / $853.04	Professional		$328.32	$451.00	$853.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.69 / $57.71 / $145.26	Professional	26	$49.69	$57.71	$145.26
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.79 / $382.35 / $565.73	Professional	TC	$281.79	$382.35	$565.73
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $405.66 / $450.73 / $536.37	Professional		$405.66	$450.73	$536.37
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $48.34 / $53.71 / $96.68	Professional	26	$48.34	$53.71	$96.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $357.32 / $397.02 / $472.45	Professional	TC	$357.32	$397.02	$472.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $275.47 / $571.73 / $1,177.60	Professional		$275.47	$571.73	$1,177.60
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.78 / $77.94 / $143.21	Professional	26	$49.78	$77.94	$143.21
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $239.38 / $509.87 / $1,034.40	Professional	TC	$239.38	$509.87	$1,034.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $335.98 / $517.47 / $705.65	Professional		$335.98	$517.47	$705.65
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 $297.45 / $457.63 / $621.41	Professional	TC	$297.45	$457.63	$621.41
United Facility/Professional Professional Modifier Low / Median / High Price $185.30 / $425.94 / $844.52	Professional		$185.30	$425.94	$844.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $43.79 / $59.55 / $110.34	Professional	26	$43.79	$59.55	$110.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $151.13 / $373.06 / $741.38	Professional	TC	$151.13	$373.06	$741.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $332.92 / $533.27 / $666.59	Professional		$332.92	$533.27	$666.59
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $39.75 / $64.58 / $81.54	Professional	26	$39.75	$64.58	$81.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $293.17 / $468.04 / $585.04	Professional	TC	$293.17	$468.04	$585.04