Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $99.35 / $126.00 / $250.74	Facility	26	$99.35	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,741.65	Professional		$400.00	$475.00	$1,741.65
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.96 / $140.00 / $461.00	Professional	26	$89.96	$140.00	$461.00
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 $617.73 / $629.50 / $861.01	Professional		$617.73	$629.50	$861.01
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.17 / $97.49 / $117.67	Professional	26	$86.17	$97.49	$117.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $516.72 / $532.01 / $774.84	Professional	TC	$516.72	$532.01	$774.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.08 / $686.42 / $1,249.04	Professional		$311.08	$686.42	$1,249.04
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.09 / $101.74 / $197.11	Professional	26	$66.09	$101.74	$197.11
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $242.21 / $597.30 / $1,081.97	Professional	TC	$242.21	$597.30	$1,081.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $364.35 / $470.01 / $795.34	Professional		$364.35	$470.01	$795.34
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.25 / $102.53 / $147.53	Professional	26	$84.25	$102.53	$147.53
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $278.91 / $359.79 / $636.49	Professional	TC	$278.91	$359.79	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $338.76 / $508.14 / $1,242.11	Professional		$338.76	$508.14	$1,242.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.78 / $88.75 / $151.38	Professional	26	$42.78	$88.75	$151.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $266.06 / $429.03 / $1,008.10	Professional	TC	$266.06	$429.03	$1,008.10
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $291.48 / $397.67 / $516.97	Professional		$291.48	$397.67	$516.97
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.34 / $89.63 / $116.52	Professional	26	$68.34	$89.63	$116.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $223.13 / $308.04 / $393.79	Professional	TC	$223.13	$308.04	$393.79