Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $117.39 / $151.66 / $170.63	Facility	26	$117.39	$151.66	$170.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $198.07 / $234.00 / $524.47	Professional		$198.07	$234.00	$524.47
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.39 / $133.37 / $276.64	Professional	26	$117.39	$133.37	$276.64
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $78.31 / $91.70 / $148.78	Professional	TC	$78.31	$91.70	$148.78
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $188.00 / $208.89 / $376.00	Professional		$188.00	$208.89	$376.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $107.68 / $119.65 / $215.36	Professional	26	$107.68	$119.65	$215.36
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $80.31 / $89.24 / $160.63	Professional	TC	$80.31	$89.24	$160.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $279.35 / $523.27	Professional		$113.94	$279.35	$523.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.78 / $182.99 / $330.72	Professional	26	$115.78	$182.99	$330.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $70.34 / $130.07 / $225.70	Professional	TC	$70.34	$130.07	$225.70
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $160.03 / $234.71 / $320.06	Professional		$160.03	$234.71	$320.06
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $97.99 / $143.72 / $195.98	Professional	26	$97.99	$143.72	$195.98
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $62.04 / $91.37 / $124.08	Professional	TC	$62.04	$91.37	$124.08
United Facility/Professional Professional Modifier Low / Median / High Price $186.09 / $251.00 / $444.67	Professional		$186.09	$251.00	$444.67
United Facility/Professional Professional Modifier 26 Low / Median / High Price $106.79 / $159.06 / $306.20	Professional	26	$106.79	$159.06	$306.20
United Facility/Professional Professional Modifier TC Low / Median / High Price $79.00 / $113.83 / $187.75	Professional	TC	$79.00	$113.83	$187.75
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $185.56 / $245.12 / $306.41	Professional		$185.56	$245.12	$306.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $113.62 / $150.25 / $189.59	Professional	26	$113.62	$150.25	$189.59
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $71.94 / $93.44 / $116.81	Professional	TC	$71.94	$93.44	$116.81