Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,335.46	Professional		$400.00	$475.00	$1,335.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.27 / $126.00 / $337.68	Professional	26	$87.27	$126.00	$337.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $816.61	Professional	TC	$281.41	$335.00	$816.61
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $476.76 / $568.45 / $648.75	Professional		$476.76	$568.45	$648.75
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.90 / $97.00 / $110.87	Professional	26	$86.90	$97.00	$110.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.86 / $471.45 / $533.47	Professional	TC	$389.86	$471.45	$533.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $300.33 / $558.73 / $939.03	Professional		$300.33	$558.73	$939.03
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.80 / $101.39 / $196.43	Professional	26	$65.80	$101.39	$196.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $231.80 / $441.26 / $729.15	Professional	TC	$231.80	$441.26	$729.15
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $350.73 / $452.44 / $765.18	Professional		$350.73	$452.44	$765.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.85 / $102.08 / $151.08	Professional	26	$83.85	$102.08	$151.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $265.66 / $342.70 / $586.78	Professional	TC	$265.66	$342.70	$586.78
United Facility/Professional Professional Modifier Low / Median / High Price $252.51 / $448.17 / $793.62	Professional		$252.51	$448.17	$793.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.40 / $88.15 / $143.63	Professional	26	$46.40	$88.15	$143.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $221.07 / $355.77 / $692.02	Professional	TC	$221.07	$355.77	$692.02
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $280.58 / $382.59 / $497.37	Professional		$280.58	$382.59	$497.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.06 / $89.20 / $115.96	Professional	26	$68.06	$89.20	$115.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $212.53 / $293.39 / $375.06	Professional	TC	$212.53	$293.39	$375.06