Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $119.74 / $126.00 / $151.19	Facility	26	$119.74	$126.00	$151.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,786.78	Professional		$400.00	$475.00	$1,786.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.25 / $140.00 / $439.23	Professional	26	$103.25	$140.00	$439.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,501.57	Professional	TC	$281.41	$335.00	$1,501.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $639.65 / $710.72 / $967.48	Professional		$639.65	$710.72	$967.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $116.26 / $143.59	Professional	26	$103.26	$116.26	$143.59
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $535.01 / $594.46 / $864.22	Professional	TC	$535.01	$594.46	$864.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $369.12 / $719.55 / $1,358.39	Professional		$369.12	$719.55	$1,358.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.52 / $120.82 / $231.02	Professional	26	$79.52	$120.82	$231.02
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $286.56 / $572.60 / $1,180.57	Professional	TC	$286.56	$572.60	$1,180.57
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $430.59 / $555.46 / $939.50	Professional		$430.59	$555.46	$939.50
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $101.63 / $123.08 / $167.64	Professional	26	$101.63	$123.08	$167.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $327.38 / $422.32 / $723.26	Professional	TC	$327.38	$422.32	$723.26
United Facility/Professional Professional Modifier Low / Median / High Price $396.44 / $580.90 / $1,119.83	Professional		$396.44	$580.90	$1,119.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $115.46 / $253.15	Professional	26	$53.83	$115.46	$253.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $320.26 / $452.14 / $988.27	Professional	TC	$320.26	$452.14	$988.27
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $344.47 / $469.75 / $610.67	Professional		$344.47	$469.75	$610.67
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $82.58 / $108.12 / $140.56	Professional	26	$82.58	$108.12	$140.56
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $261.89 / $361.63 / $462.31	Professional	TC	$261.89	$361.63	$462.31