Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.28 / $125.89 / $251.19	Facility	26	$81.28	$125.89	$251.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $549.54 / $1,698.24	Professional		$363.08	$549.54	$1,698.24
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $144.54 / $323.59	Professional	26	$70.79	$144.54	$323.59
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $380.19 / $1,096.48	Professional	TC	$263.03	$380.19	$1,096.48
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $446.68 / $691.83	Professional		$95.50	$446.68	$691.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $87.10 / $109.65	Professional	26	$81.28	$87.10	$109.65
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $354.81 / $398.11 / $457.09	Professional	TC	$354.81	$398.11	$457.09
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	26	$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $630.96 / $1,202.26	Professional		$295.12	$630.96	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $93.33 / $181.97	Professional	26	$54.95	$93.33	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $524.81 / $1,096.48	Professional	TC	$234.42	$524.81	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $398.11 / $741.31	Professional		$338.84	$398.11	$741.31
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $67.61 / $77.62 / $104.71	Professional	26	$67.61	$77.62	$104.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $616.60	Professional	TC	$275.42	$323.59	$616.60
United Facility/Professional Professional Modifier Low / Median / High Price $331.13 / $501.19 / $1,096.48	Professional		$331.13	$501.19	$1,096.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $131.83	Professional	26	$51.29	$81.28	$131.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $416.87 / $977.24	Professional	TC	$263.03	$416.87	$977.24
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $398.11 / $549.54	Professional		$346.74	$398.11	$549.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $70.79 / $81.28 / $107.15	Professional	26	$70.79	$81.28	$107.15
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $275.42 / $323.59 / $446.68	Professional	TC	$275.42	$323.59	$446.68