Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.93 / $126.00 / $151.19	Facility	26	$89.93	$126.00	$151.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.00 / $475.00 / $2,069.62	Professional		$380.00	$475.00	$2,069.62
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $322.00	Professional	26	$85.00	$140.00	$322.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $801.32	Professional	TC	$281.41	$335.00	$801.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $485.60 / $539.55 / $610.73	Professional		$485.60	$539.55	$610.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $77.45 / $88.78 / $101.47	Professional	26	$77.45	$88.78	$101.47
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $405.70 / $450.78 / $510.09	Professional	TC	$405.70	$450.78	$510.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.24 / $547.54 / $883.27	Professional		$282.24	$547.54	$883.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $91.61 / $179.03	Professional	26	$59.82	$91.61	$179.03
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.60 / $433.26 / $715.31	Professional	TC	$219.60	$433.26	$715.31
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $327.22 / $422.11 / $714.42	Professional		$327.22	$422.11	$714.42
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.30 / $92.80 / $128.01	Professional	26	$76.30	$92.80	$128.01
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $249.89 / $322.36 / $552.10	Professional	TC	$249.89	$322.36	$552.10
United Facility/Professional Professional Modifier Low / Median / High Price $297.08 / $433.00 / $772.19	Professional		$297.08	$433.00	$772.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $45.95 / $88.33 / $169.43	Professional	26	$45.95	$88.33	$169.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.27 / $346.62 / $772.30	Professional	TC	$229.27	$346.62	$772.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $261.77 / $357.21 / $464.37	Professional		$261.77	$357.21	$464.37
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $61.86 / $81.17 / $105.52	Professional	26	$61.86	$81.17	$105.52
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $199.91 / $276.05 / $352.89	Professional	TC	$199.91	$276.05	$352.89