Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.35 / $151.19 / $250.74	Facility	26	$119.35	$151.19	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $393.92 / $475.00 / $2,201.46	Professional		$393.92	$475.00	$2,201.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.04 / $140.00 / $513.24	Professional	26	$103.04	$140.00	$513.24
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,256.01	Professional	TC	$281.41	$335.00	$1,256.01
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $592.95 / $608.92 / $967.48	Professional		$592.95	$608.92	$967.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $115.41 / $131.91	Professional	26	$103.26	$115.41	$131.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $472.30 / $493.52 / $864.22	Professional	TC	$472.30	$493.52	$864.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.64 / $654.28 / $1,225.59	Professional		$303.64	$654.28	$1,225.59
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.27 / $120.41 / $235.44	Professional	26	$79.27	$120.41	$235.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.39 / $497.12 / $1,041.68	Professional	TC	$221.39	$497.12	$1,041.68
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $356.59 / $460.00 / $776.04	Professional		$356.59	$460.00	$776.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $101.27 / $122.28 / $167.01	Professional	26	$101.27	$122.28	$167.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $253.73 / $327.31 / $636.49	Professional	TC	$253.73	$327.31	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $336.21 / $514.30 / $1,050.65	Professional		$336.21	$514.30	$1,050.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.63 / $106.66 / $178.34	Professional	26	$53.63	$106.66	$178.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.82 / $383.76 / $889.64	Professional	TC	$250.82	$383.76	$889.64
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $285.27 / $388.02 / $504.43	Professional		$285.27	$388.02	$504.43
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $82.30 / $107.73 / $140.05	Professional	26	$82.30	$107.73	$140.05
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $202.98 / $280.29 / $358.32	Professional	TC	$202.98	$280.29	$358.32