Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $89.12 / $121.69 / $177.36	Facility	26	$89.12	$121.69	$177.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.04 / $512.36 / $1,085.78	Professional		$351.04	$512.36	$1,085.78
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $114.18 / $408.80	Professional	26	$89.13	$114.18	$408.80
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $261.91 / $361.44 / $701.91	Professional	TC	$261.91	$361.44	$701.91
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $491.43 / $546.03 / $717.49	Professional		$491.43	$546.03	$717.49
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $114.93 / $114.93 / $149.41	Professional	26	$114.93	$114.93	$149.41
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $388.00 / $431.10 / $566.48	Professional	TC	$388.00	$431.10	$566.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $626.54 / $1,067.10	Professional		$330.00	$626.54	$1,067.10
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.17 / $122.98 / $241.86	Professional	26	$81.17	$122.98	$241.86
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $245.67 / $467.47 / $793.83	Professional	TC	$245.67	$467.47	$793.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $398.71 / $471.28 / $719.92	Professional		$398.71	$471.28	$719.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.23 / $120.80 / $169.67	Professional	26	$103.23	$120.80	$169.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $293.89 / $352.67 / $550.24	Professional	TC	$293.89	$352.67	$550.24
United Facility/Professional Professional Modifier Low / Median / High Price $318.45 / $513.32 / $1,037.97	Professional		$318.45	$513.32	$1,037.97
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.74 / $111.88 / $207.38	Professional	26	$57.74	$111.88	$207.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $235.78 / $345.40 / $578.29	Professional	TC	$235.78	$345.40	$578.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $320.45 / $436.37 / $567.28	Professional		$320.45	$436.37	$567.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $83.95 / $109.82 / $142.77	Professional	26	$83.95	$109.82	$142.77
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $236.51 / $326.55 / $417.45	Professional	TC	$236.51	$326.55	$417.45