Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $151.19 / $250.74	Facility	26	$126.00	$151.19	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,923.61	Professional		$400.00	$475.00	$1,923.61
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $110.32 / $155.65 / $394.66	Professional	26	$110.32	$155.65	$394.66
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,120.00	Professional	TC	$281.41	$335.00	$1,120.00
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $483.36 / $525.98 / $997.71	Professional		$483.36	$525.98	$997.71
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $121.15 / $129.12 / $162.32	Professional	26	$121.15	$129.12	$162.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $362.21 / $402.45 / $874.21	Professional	TC	$362.21	$402.45	$874.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.91 / $590.00 / $1,263.00	Professional		$285.91	$590.00	$1,263.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.09 / $139.07 / $254.92	Professional	26	$85.09	$139.07	$254.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.88 / $426.42 / $1,099.31	Professional	TC	$197.88	$426.42	$1,099.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $336.53 / $434.12 / $784.17	Professional		$336.53	$434.12	$784.17
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.30 / $134.25 / $216.36	Professional	26	$108.30	$134.25	$216.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $226.53 / $292.22 / $597.49	Professional	TC	$226.53	$292.22	$597.49
United Facility/Professional Professional Modifier Low / Median / High Price $309.48 / $485.15 / $1,137.80	Professional		$309.48	$485.15	$1,137.80
United Facility/Professional Professional Modifier 26 Low / Median / High Price $73.09 / $117.29 / $192.14	Professional	26	$73.09	$117.29	$192.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $224.58 / $336.88 / $826.19	Professional	TC	$224.58	$336.88	$826.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $269.22 / $365.42 / $475.05	Professional		$269.22	$365.42	$475.05
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $88.00 / $115.21 / $149.77	Professional	26	$88.00	$115.21	$149.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $181.22 / $250.21 / $319.88	Professional	TC	$181.22	$250.21	$319.88