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 / $250.74	Facility	26	$119.74	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $262.89 / $475.00 / $2,205.48	Professional		$262.89	$475.00	$2,205.48
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $140.00 / $527.00	Professional	26	$104.71	$140.00	$527.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $931.29	Professional	TC	$281.41	$335.00	$931.29
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $589.77 / $607.41 / $967.14	Professional		$589.77	$607.41	$967.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $102.87 / $115.83 / $143.07	Professional	26	$102.87	$115.83	$143.07
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $469.12 / $491.58 / $864.26	Professional	TC	$469.12	$491.58	$864.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.16 / $663.18 / $1,293.83	Professional		$302.16	$663.18	$1,293.83
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.14 / $120.41 / $235.44	Professional	26	$79.14	$120.41	$235.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $219.90 / $522.71 / $1,109.13	Professional	TC	$219.90	$522.71	$1,109.13
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.50 / $457.31 / $771.40	Professional		$354.50	$457.31	$771.40
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $101.63 / $122.67 / $167.64	Professional	26	$101.63	$122.67	$167.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $251.28 / $324.14 / $636.49	Professional	TC	$251.28	$324.14	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $336.82 / $515.26 / $1,119.35	Professional		$336.82	$515.26	$1,119.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.82 / $115.06 / $253.15	Professional	26	$53.82	$115.06	$253.15
United Facility/Professional Professional Modifier TC Low / Median / High Price $251.45 / $377.18 / $917.51	Professional	TC	$251.45	$377.18	$917.51
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $283.60 / $385.70 / $501.41	Professional		$283.60	$385.70	$501.41
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 $201.02 / $277.58 / $354.87	Professional	TC	$201.02	$277.58	$354.87