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 / $162.46	Facility	26	$119.74	$126.00	$162.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $375.00 / $475.00 / $1,785.63	Professional		$375.00	$475.00	$1,785.63
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.61 / $140.00 / $439.23	Professional	26	$115.61	$140.00	$439.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,501.52	Professional	TC	$281.41	$335.00	$1,501.52
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $600.14 / $666.83 / $967.48	Professional		$600.14	$666.83	$967.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $116.26 / $132.88	Professional	26	$103.26	$116.26	$132.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $495.51 / $550.57 / $864.22	Professional	TC	$495.51	$550.57	$864.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $348.29 / $682.05 / $1,357.63	Professional		$348.29	$682.05	$1,357.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.78 / $121.44 / $236.92	Professional	26	$79.78	$121.44	$236.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $265.43 / $537.23 / $1,093.91	Professional	TC	$265.43	$537.23	$1,093.91
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $405.06 / $522.53 / $883.22	Professional		$405.06	$522.53	$883.22
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $101.63 / $122.67 / $168.25	Professional	26	$101.63	$122.67	$168.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $301.85 / $389.39 / $667.00	Professional	TC	$301.85	$389.39	$667.00
United Facility/Professional Professional Modifier Low / Median / High Price $383.17 / $547.97 / $1,066.64	Professional		$383.17	$547.97	$1,066.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $49.02 / $102.76 / $178.96	Professional	26	$49.02	$102.76	$178.96
United Facility/Professional Professional Modifier TC Low / Median / High Price $298.62 / $455.75 / $939.46	Professional	TC	$298.62	$455.75	$939.46
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $324.05 / $441.61 / $574.09	Professional		$324.05	$441.61	$574.09
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 $241.48 / $333.50 / $426.35	Professional	TC	$241.48	$333.50	$426.35