Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $140.68 / $181.51 / $204.48	Facility	26	$140.68	$181.51	$204.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $228.88 / $263.19 / $611.34	Professional		$228.88	$263.19	$611.34
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $140.68 / $158.68 / $312.62	Professional	26	$140.68	$158.68	$312.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $87.95 / $103.76 / $165.56	Professional	TC	$87.95	$103.76	$165.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $219.08 / $243.42 / $438.16	Professional		$219.08	$243.42	$438.16
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $128.22 / $142.46 / $256.44	Professional	26	$128.22	$142.46	$256.44
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $90.86 / $100.96 / $181.72	Professional	TC	$90.86	$100.96	$181.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $315.92 / $612.34	Professional		$113.94	$315.92	$612.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $138.54 / $217.29 / $393.84	Professional	26	$138.54	$217.29	$393.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $79.42 / $146.40 / $253.40	Professional	TC	$79.42	$146.40	$253.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $186.49 / $273.52 / $372.98	Professional		$186.49	$273.52	$372.98
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $117.33 / $172.08 / $234.66	Professional	26	$117.33	$172.08	$234.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $69.15 / $101.78 / $138.30	Professional	TC	$69.15	$101.78	$138.30
United Facility/Professional Professional Modifier Low / Median / High Price $216.34 / $295.74 / $504.92	Professional		$216.34	$295.74	$504.92
United Facility/Professional Professional Modifier 26 Low / Median / High Price $127.17 / $172.77 / $303.82	Professional	26	$127.17	$172.77	$303.82
United Facility/Professional Professional Modifier TC Low / Median / High Price $88.13 / $125.79 / $201.10	Professional	TC	$88.13	$125.79	$201.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.43 / $285.60 / $357.00	Professional		$222.43	$285.60	$357.00
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $139.94 / $179.91 / $226.89	Professional	26	$139.94	$179.91	$226.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $82.48 / $104.08 / $130.10	Professional	TC	$82.48	$104.08	$130.10