Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $128.06 / $250.74	Facility	26	$126.00	$128.06	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.76 / $475.00 / $1,783.26	Professional		$366.76	$475.00	$1,783.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $111.37 / $154.00 / $536.75	Professional	26	$111.37	$154.00	$536.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $271.19 / $335.00 / $1,116.68	Professional	TC	$271.19	$335.00	$1,116.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $481.96 / $534.78 / $954.00	Professional		$481.96	$534.78	$954.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $113.38 / $124.26 / $162.32	Professional	26	$113.38	$124.26	$162.32
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $370.12 / $411.25 / $840.62	Professional	TC	$370.12	$411.25	$840.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $285.32 / $590.00 / $1,251.15	Professional		$285.32	$590.00	$1,251.15
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.09 / $131.38 / $251.80	Professional	26	$85.09	$131.38	$251.80
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $197.28 / $425.22 / $1,099.31	Professional	TC	$197.28	$425.22	$1,099.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $335.83 / $433.22 / $772.53	Professional		$335.83	$433.22	$772.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.30 / $132.00 / $199.31	Professional	26	$108.30	$132.00	$199.31
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $225.83 / $291.32 / $595.85	Professional	TC	$225.83	$291.32	$595.85
United Facility/Professional Professional Modifier Low / Median / High Price $308.87 / $447.37 / $1,101.42	Professional		$308.87	$447.37	$1,101.42
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.78 / $111.20 / $192.14	Professional	26	$58.78	$111.20	$192.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $218.41 / $335.93 / $823.68	Professional	TC	$218.41	$335.93	$823.68
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $268.66 / $364.65 / $474.05	Professional		$268.66	$364.65	$474.05
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 $180.66 / $249.44 / $318.89	Professional	TC	$180.66	$249.44	$318.89