Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.65 / $918.86 / $1,220.69	Facility		$98.65	$918.86	$1,220.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $370.19 / $439.96 / $1,055.89	Professional		$370.19	$439.96	$1,055.89
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $127.31 / $135.19 / $362.30	Professional	26	$127.31	$135.19	$362.30
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $237.40 / $296.60 / $794.88	Professional	TC	$237.40	$296.60	$794.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $431.60 / $501.66 / $652.66	Professional		$431.60	$501.66	$652.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $142.09 / $148.30 / $192.80	Professional	26	$142.09	$148.30	$192.80
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $280.52 / $325.42 / $459.21	Professional	TC	$280.52	$325.42	$459.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $238.77 / $238.77 / $238.77	Facility		$238.77	$238.77	$238.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $342.83 / $493.71 / $1,255.31	Professional		$342.83	$493.71	$1,255.31
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $126.53 / $178.98 / $384.66	Professional	26	$126.53	$178.98	$384.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.16 / $335.96 / $857.92	Professional	TC	$221.16	$335.96	$857.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $372.80 / $484.40 / $904.94	Professional		$372.80	$484.40	$904.94
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $127.45 / $164.41 / $272.56	Professional	26	$127.45	$164.41	$272.56
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.36 / $325.24 / $629.87	Professional	TC	$245.36	$325.24	$629.87
United Facility/Professional Professional Modifier Low / Median / High Price $313.60 / $444.03 / $754.52	Professional		$313.60	$444.03	$754.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $112.22 / $147.28 / $253.54	Professional	26	$112.22	$147.28	$253.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $194.11 / $283.14 / $500.98	Professional	TC	$194.11	$283.14	$500.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $271.70 / $428.72 / $529.29	Professional		$271.70	$428.72	$529.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $92.89 / $146.57 / $182.81	Professional	26	$92.89	$146.57	$182.81
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $178.83 / $282.16 / $346.49	Professional	TC	$178.83	$282.16	$346.49