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 / $152.46	Facility	26	$89.93	$126.00	$152.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $384.14 / $475.00 / $1,828.85	Professional		$384.14	$475.00	$1,828.85
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.00 / $140.00 / $385.00	Professional	26	$85.00	$140.00	$385.00
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 $493.25 / $548.05 / $620.16	Professional		$493.25	$548.05	$620.16
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 $413.35 / $459.28 / $519.70	Professional	TC	$413.35	$459.28	$519.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $282.54 / $550.00 / $883.27	Professional		$282.54	$550.00	$883.27
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $59.82 / $92.06 / $178.29	Professional	26	$59.82	$92.06	$178.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $220.20 / $434.89 / $725.46	Professional	TC	$220.20	$434.89	$725.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $328.97 / $424.37 / $718.28	Professional		$328.97	$424.37	$718.28
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 $251.63 / $324.60 / $555.94	Professional	TC	$251.63	$324.60	$555.94
United Facility/Professional Professional Modifier Low / Median / High Price $287.32 / $427.54 / $777.37	Professional		$287.32	$427.54	$777.37
United Facility/Professional Professional Modifier 26 Low / Median / High Price $40.57 / $83.73 / $170.84	Professional	26	$40.57	$83.73	$170.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.27 / $346.62 / $639.53	Professional	TC	$229.27	$346.62	$639.53
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $263.18 / $359.14 / $466.88	Professional		$263.18	$359.14	$466.88
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 $201.30 / $277.97 / $355.37	Professional	TC	$201.30	$277.97	$355.37