Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $81.68 / $126.00 / $250.74	Facility	26	$81.68	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,386.94	Professional		$400.00	$475.00	$1,386.94
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $322.00	Professional	26	$85.00	$140.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $863.05	Professional	TC	$281.41	$335.00	$863.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $597.59 / $609.04 / $861.01	Professional		$597.59	$609.04	$861.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $80.23 / $83.40 / $94.19	Professional	26	$80.23	$83.40	$94.19
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $514.19 / $528.79 / $774.84	Professional	TC	$514.19	$528.79	$774.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $297.89 / $655.48 / $1,249.04	Professional		$297.89	$655.48	$1,249.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.36 / $94.40 / $183.70	Professional	26	$54.36	$94.40	$183.70
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $241.02 / $594.80 / $1,074.43	Professional	TC	$241.02	$594.80	$1,074.43
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $348.14 / $449.10 / $761.12	Professional		$348.14	$449.10	$761.12
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.26 / $90.66 / $144.60	Professional	26	$69.26	$90.66	$144.60
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $277.86 / $358.44 / $636.49	Professional	TC	$277.86	$358.44	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $328.40 / $492.60 / $1,128.32	Professional		$328.40	$492.60	$1,128.32
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.57 / $83.63 / $146.38	Professional	26	$49.57	$83.63	$146.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $257.60 / $396.24 / $1,003.13	Professional	TC	$257.60	$396.24	$1,003.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $278.51 / $380.56 / $494.42	Professional		$278.51	$380.56	$494.42
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $73.68 / $95.78	Professional	26	$56.22	$73.68	$95.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $222.29 / $306.88 / $392.31	Professional	TC	$222.29	$306.88	$392.31