Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.11 / $126.00 / $162.46	Facility	26	$122.11	$126.00	$162.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.33 / $475.00 / $2,207.11	Professional		$371.33	$475.00	$2,207.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $105.21 / $140.00 / $338.00	Professional	26	$105.21	$140.00	$338.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,236.10	Professional	TC	$281.41	$335.00	$1,236.10
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $587.51 / $686.79 / $973.90	Professional		$587.51	$686.79	$973.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $108.15 / $118.51 / $149.83	Professional	26	$108.15	$118.51	$149.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $464.05 / $568.28 / $865.75	Professional	TC	$464.05	$568.28	$865.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.70 / $657.04 / $1,293.46	Professional		$301.70	$657.04	$1,293.46
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $127.52 / $240.91	Professional	26	$81.38	$127.52	$240.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $217.52 / $501.09 / $1,097.93	Professional	TC	$217.52	$501.09	$1,097.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.06 / $456.74 / $770.20	Professional		$354.06	$456.74	$770.20
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.60 / $121.23 / $170.89	Professional	26	$103.60	$121.23	$170.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $248.84 / $321.00 / $636.49	Professional	TC	$248.84	$321.00	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $329.59 / $515.59 / $1,075.82	Professional		$329.59	$515.59	$1,075.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $50.21 / $111.88 / $213.71	Professional	26	$50.21	$111.88	$213.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $249.56 / $410.46 / $827.32	Professional	TC	$249.56	$410.46	$827.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $283.25 / $385.10 / $500.63	Professional		$283.25	$385.10	$500.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $84.17 / $110.21 / $143.27	Professional	26	$84.17	$110.21	$143.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $199.07 / $274.89 / $351.42	Professional	TC	$199.07	$274.89	$351.42