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 $347.37 / $425.00 / $1,372.11	Professional		$347.37	$425.00	$1,372.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.23 / $126.00 / $322.00	Professional	26	$89.23	$126.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $238.13 / $328.25 / $689.84	Professional	TC	$238.13	$328.25	$689.84
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $411.98 / $457.75 / $555.66	Professional		$411.98	$457.75	$555.66
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.88 / $96.33 / $110.11	Professional	26	$85.88	$96.33	$110.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $325.27 / $361.42 / $469.78	Professional	TC	$325.27	$361.42	$469.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.41 / $490.00 / $863.48	Professional		$242.41	$490.00	$863.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.23 / $100.51 / $192.07	Professional	26	$66.23	$100.51	$192.07
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $173.77 / $372.97 / $681.96	Professional	TC	$173.77	$372.97	$681.96
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $284.61 / $367.15 / $623.51	Professional		$284.61	$367.15	$623.51
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.32 / $102.49 / $151.68	Professional	26	$84.32	$102.49	$151.68
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $198.98 / $256.68 / $521.03	Professional	TC	$198.98	$256.68	$521.03
United Facility/Professional Professional Modifier Low / Median / High Price $262.01 / $375.97 / $834.57	Professional		$262.01	$375.97	$834.57
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.64 / $87.71 / $149.63	Professional	26	$44.64	$87.71	$149.63
United Facility/Professional Professional Modifier TC Low / Median / High Price $191.58 / $291.33 / $659.51	Professional	TC	$191.58	$291.33	$659.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $227.69 / $309.45 / $402.29	Professional		$227.69	$309.45	$402.29
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.50 / $89.70 / $116.61	Professional	26	$68.50	$89.70	$116.61
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $159.18 / $219.75 / $280.92	Professional	TC	$159.18	$219.75	$280.92