Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $126.00 / $126.00 / $126.00	Facility	26	$126.00	$126.00	$126.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $425.00 / $2,187.03	Professional		$400.00	$425.00	$2,187.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.57 / $126.00 / $241.17	Professional	26	$85.57	$126.00	$241.17
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $299.00 / $1,088.27	Professional	TC	$281.41	$299.00	$1,088.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $477.05 / $573.66 / $652.60	Professional		$477.05	$573.66	$652.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $87.23 / $96.51 / $110.31	Professional	26	$87.23	$96.51	$110.31
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.82 / $477.16 / $539.92	Professional	TC	$389.82	$477.16	$539.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.08 / $557.32 / $944.68	Professional		$302.08	$557.32	$944.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.44 / $103.80 / $195.15	Professional	26	$66.44	$103.80	$195.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $250.62 / $436.54 / $720.40	Professional	TC	$250.62	$436.54	$720.40
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.04 / $458.00 / $774.30	Professional		$355.04	$458.00	$774.30
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $84.52 / $103.08 / $151.07	Professional	26	$84.52	$103.08	$151.07
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.14 / $347.19 / $594.48	Professional	TC	$269.14	$347.19	$594.48
United Facility/Professional Professional Modifier Low / Median / High Price $262.48 / $451.07 / $858.51	Professional		$262.48	$451.07	$858.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.76 / $92.03 / $199.77	Professional	26	$51.76	$92.03	$199.77
United Facility/Professional Professional Modifier TC Low / Median / High Price $219.19 / $358.36 / $712.32	Professional	TC	$219.19	$358.36	$712.32
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.02 / $387.15 / $503.30	Professional		$284.02	$387.15	$503.30
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.72 / $89.91 / $116.88	Professional	26	$68.72	$89.91	$116.88
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $215.31 / $297.24 / $380.00	Professional	TC	$215.31	$297.24	$380.00