Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.23 / $125.89 / $151.36	Facility	26	$120.23	$125.89	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $478.63 / $2,238.72	Professional		$213.80	$478.63	$2,238.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $208.93 / $501.19	Professional	26	$102.33	$208.93	$501.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.84 / $436.52 / $1,288.25	Professional	TC	$281.84	$436.52	$1,288.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $512.86 / $870.96	Professional		$125.89	$512.86	$870.96
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $141.25 / $162.18	Professional	26	$120.23	$141.25	$162.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.05 / $436.52 / $501.19	Professional	TC	$389.05	$436.52	$501.19
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	26	$165.96	$165.96	$165.96
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $645.65 / $1,348.96	Professional		$346.74	$645.65	$1,348.96
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $120.23 / $229.09	Professional	26	$79.43	$120.23	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $489.78 / $1,096.48	Professional	TC	$263.03	$489.78	$1,096.48
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $467.74 / $758.58	Professional		$398.11	$467.74	$758.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $112.20 / $154.88	Professional	26	$100.00	$112.20	$154.88
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $346.74 / $630.96	Professional	TC	$302.00	$346.74	$630.96
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $602.56 / $1,071.52	Professional		$380.19	$602.56	$1,071.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $61.66 / $109.65 / $186.21	Professional	26	$61.66	$109.65	$186.21
United Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $457.09 / $933.25	Professional	TC	$295.12	$457.09	$933.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $467.74 / $645.65	Professional		$407.38	$467.74	$645.65
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $102.33 / $117.49 / $154.88	Professional	26	$102.33	$117.49	$154.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $346.74 / $478.63	Professional	TC	$302.00	$346.74	$478.63