Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $125.89 / $125.89 / $125.89	Facility	26	$125.89	$125.89	$125.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $501.19 / $2,187.76	Professional		$346.74	$501.19	$2,187.76
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $128.82 / $295.12	Professional	26	$85.11	$128.82	$295.12
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $363.08 / $891.25	Professional	TC	$257.04	$363.08	$891.25
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $426.58 / $524.81	Professional		$104.71	$426.58	$524.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $104.71 / $134.90	Professional	26	$85.11	$104.71	$134.90
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $389.05 / $446.68	Professional	TC	$346.74	$389.05	$446.68
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $138.04 / $138.04 / $138.04	Facility	26	$138.04	$138.04	$138.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $537.03 / $954.99	Professional		$295.12	$537.03	$954.99
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $100.00 / $181.97	Professional	26	$66.07	$100.00	$181.97
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $407.38 / $758.58	Professional	TC	$229.09	$407.38	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $660.69	Professional		$354.81	$407.38	$660.69
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $95.50 / $128.82	Professional	26	$83.18	$95.50	$128.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $549.54	Professional	TC	$269.15	$316.23	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $467.74 / $794.33	Professional		$295.12	$467.74	$794.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $91.20 / $154.88	Professional	26	$51.29	$91.20	$154.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $363.08 / $676.08	Professional	TC	$239.88	$363.08	$676.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $416.87 / $562.34	Professional		$354.81	$416.87	$562.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $85.11 / $100.00 / $128.82	Professional	26	$85.11	$100.00	$128.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $269.15 / $316.23 / $436.52	Professional	TC	$269.15	$316.23	$436.52