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 $285.20 / $475.00 / $1,786.73	Professional		$285.20	$475.00	$1,786.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $107.42 / $140.00 / $473.51	Professional	26	$107.42	$140.00	$473.51
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 $616.32 / $669.31 / $967.48	Professional		$616.32	$669.31	$967.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $103.26 / $115.83 / $132.40	Professional	26	$103.26	$115.83	$132.40
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $507.34 / $553.48 / $864.22	Professional	TC	$507.34	$553.48	$864.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.88 / $681.39 / $1,357.63	Professional		$346.88	$681.39	$1,357.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.52 / $121.44 / $236.18	Professional	26	$79.52	$121.44	$236.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $264.24 / $538.28 / $1,093.77	Professional	TC	$264.24	$538.28	$1,093.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $404.01 / $521.16 / $880.92	Professional		$404.01	$521.16	$880.92
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 $300.80 / $388.03 / $664.68	Professional	TC	$300.80	$388.03	$664.68
United Facility/Professional Professional Modifier Low / Median / High Price $382.56 / $546.51 / $1,068.14	Professional		$382.56	$546.51	$1,068.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.83 / $109.71 / $189.37	Professional	26	$53.83	$109.71	$189.37
United Facility/Professional Professional Modifier TC Low / Median / High Price $298.00 / $423.99 / $920.55	Professional	TC	$298.00	$423.99	$920.55
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.20 / $440.46 / $572.60	Professional		$323.20	$440.46	$572.60
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 $240.64 / $332.34 / $424.88	Professional	TC	$240.64	$332.34	$424.88