Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $151.36 / $251.19	Facility	26	$120.23	$151.36	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $602.56 / $2,754.23	Professional		$371.54	$602.56	$2,754.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.72 / $199.53 / $512.86	Professional	26	$97.72	$199.53	$512.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $407.38 / $1,548.82	Professional	TC	$257.04	$407.38	$1,548.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $457.09 / $645.65	Professional		$141.25	$457.09	$645.65
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $125.89 / $154.88	Professional	26	$117.49	$125.89	$154.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $331.13 / $524.81	Professional	TC	$323.59	$331.13	$524.81
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $616.60 / $1,230.27	Professional		$302.00	$616.60	$1,230.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $120.23 / $229.09	Professional	26	$79.43	$120.23	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $426.58 / $1,096.48	Professional	TC	$218.78	$426.58	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $407.38 / $758.58	Professional		$346.74	$407.38	$758.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $112.20 / $154.88	Professional	26	$100.00	$112.20	$154.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $575.44	Professional	TC	$251.19	$295.12	$575.44
United Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $524.81 / $1,071.52	Professional		$346.74	$524.81	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $181.97	Professional	26	$61.66	$109.65	$181.97
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $398.11 / $912.01	Professional	TC	$251.19	$398.11	$912.01
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $562.34	Professional		$354.81	$416.87	$562.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $154.88	Professional	26	$102.33	$117.49	$154.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $251.19 / $295.12 / $407.38	Professional	TC	$251.19	$295.12	$407.38