Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $166.71 / $215.31 / $242.31	Facility	26	$166.71	$215.31	$242.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $264.08 / $300.86 / $673.09	Professional		$264.08	$300.86	$673.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $166.71 / $188.02 / $384.85	Professional	26	$166.71	$188.02	$384.85
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $97.38 / $115.98 / $185.02	Professional	TC	$97.38	$115.98	$185.02
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $253.90 / $282.11 / $507.80	Professional		$253.90	$282.11	$507.80
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $152.21 / $169.12 / $304.42	Professional	26	$152.21	$169.12	$304.42
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $101.70 / $112.99 / $203.40	Professional	TC	$101.70	$112.99	$203.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.94 / $367.71 / $709.31	Professional		$113.94	$367.71	$709.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $164.33 / $257.26 / $467.64	Professional	26	$164.33	$257.26	$467.64
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $89.57 / $161.19 / $280.93	Professional	TC	$89.57	$161.19	$280.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $218.24 / $320.08 / $436.47	Professional		$218.24	$320.08	$436.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $139.15 / $204.08 / $278.30	Professional	26	$139.15	$204.08	$278.30
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $79.09 / $116.43 / $158.19	Professional	TC	$79.09	$116.43	$158.19
United Facility/Professional Professional Modifier Low / Median / High Price $249.09 / $352.34 / $582.66	Professional		$249.09	$352.34	$582.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $150.97 / $215.47 / $365.46	Professional	26	$150.97	$215.47	$365.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $98.60 / $132.40 / $224.99	Professional	TC	$98.60	$132.40	$224.99
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $257.66 / $334.38 / $417.97	Professional		$257.66	$334.38	$417.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $164.28 / $213.36 / $269.14	Professional	26	$164.28	$213.36	$269.14
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $93.38 / $119.06 / $148.83	Professional	TC	$93.38	$119.06	$148.83