Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.80 / $126.00 / $162.46	Facility	26	$83.80	$126.00	$162.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $314.97 / $425.00 / $1,459.50	Professional		$314.97	$425.00	$1,459.50
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.86 / $126.00 / $315.00	Professional	26	$74.86	$126.00	$315.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $219.86 / $299.00 / $931.29	Professional	TC	$219.86	$299.00	$931.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $432.48 / $440.10 / $558.92	Professional		$432.48	$440.10	$558.92
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $57.22 / $81.39 / $92.10	Professional	26	$57.22	$81.39	$92.10
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $347.87 / $358.71 / $488.81	Professional	TC	$347.87	$358.71	$488.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.75 / $490.00 / $831.50	Professional		$220.75	$490.00	$831.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.23 / $79.14 / $152.96	Professional	26	$54.23	$79.14	$152.96
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $163.06 / $385.15 / $717.22	Professional	TC	$163.06	$385.15	$717.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $259.45 / $334.69 / $589.58	Professional		$259.45	$334.69	$589.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.54 / $81.97 / $116.06	Professional	26	$63.54	$81.97	$116.06
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $188.17 / $242.74 / $477.34	Professional	TC	$188.17	$242.74	$477.34
United Facility/Professional Professional Modifier Low / Median / High Price $232.37 / $335.20 / $726.21	Professional		$232.37	$335.20	$726.21
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.93 / $72.92 / $126.02	Professional	26	$29.93	$72.92	$126.02
United Facility/Professional Professional Modifier TC Low / Median / High Price $177.48 / $266.22 / $678.65	Professional	TC	$177.48	$266.22	$678.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $207.56 / $282.55 / $367.32	Professional		$207.56	$282.55	$367.32
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $74.75 / $97.18	Professional	26	$57.02	$74.75	$97.18
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $150.54 / $207.80 / $265.64	Professional	TC	$150.54	$207.80	$265.64