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 $323.59 / $512.86 / $1,412.54	Professional		$323.59	$512.86	$1,412.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $138.04 / $223.87	Professional	26	$83.18	$138.04	$223.87
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $338.84 / $707.95	Professional	TC	$229.09	$338.84	$707.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $407.38 / $512.86	Professional		$112.20	$407.38	$512.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.18 / $100.00 / $128.82	Professional	26	$83.18	$100.00	$128.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $338.84 / $467.74	Professional	TC	$302.00	$338.84	$467.74
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $131.83 / $131.83 / $131.83	Facility	26	$131.83	$131.83	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $537.03 / $977.24	Professional		$269.15	$537.03	$977.24
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $95.50 / $173.78	Professional	26	$63.10	$95.50	$173.78
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $398.11 / $758.58	Professional	TC	$204.17	$398.11	$758.58
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $363.08 / $616.60	Professional		$309.03	$363.08	$616.60
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $91.20 / $123.03	Professional	26	$79.43	$91.20	$123.03
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $275.42 / $524.81	Professional	TC	$234.42	$275.42	$524.81
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $457.09 / $831.76	Professional		$288.40	$457.09	$831.76
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.98 / $89.13 / $151.36	Professional	26	$48.98	$89.13	$151.36
United Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $354.81 / $707.95	Professional	TC	$229.09	$354.81	$707.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $371.54 / $501.19	Professional		$316.23	$371.54	$501.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $81.28 / $95.50 / $125.89	Professional	26	$81.28	$95.50	$125.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $234.42 / $275.42 / $380.19	Professional	TC	$234.42	$275.42	$380.19