Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $122.11 / $126.00 / $250.74	Facility	26	$122.11	$126.00	$250.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $372.82 / $475.00 / $2,211.19	Professional		$372.82	$475.00	$2,211.19
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.63 / $154.00 / $464.63	Professional	26	$106.63	$154.00	$464.63
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $1,501.34	Professional	TC	$281.41	$335.00	$1,501.34
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $590.04 / $688.61 / $973.90	Professional		$590.04	$688.61	$973.90
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $108.15 / $118.09 / $149.83	Professional	26	$108.15	$118.09	$149.83
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $466.58 / $570.52 / $865.75	Professional	TC	$466.58	$570.52	$865.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.89 / $658.24 / $1,295.91	Professional		$302.89	$658.24	$1,295.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $81.38 / $127.52 / $240.91	Professional	26	$81.38	$127.52	$240.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $218.71 / $501.70 / $1,097.93	Professional	TC	$218.71	$501.70	$1,097.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.45 / $458.53 / $773.28	Professional		$355.45	$458.53	$773.28
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $103.60 / $126.25 / $170.89	Professional	26	$103.60	$126.25	$170.89
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $250.24 / $322.81 / $636.49	Professional	TC	$250.24	$322.81	$636.49
United Facility/Professional Professional Modifier Low / Median / High Price $330.21 / $471.73 / $1,075.82	Professional		$330.21	$471.73	$1,075.82
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.46 / $107.68 / $183.04	Professional	26	$53.46	$107.68	$183.04
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.19 / $375.29 / $913.14	Professional	TC	$250.19	$375.29	$913.14
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.36 / $386.64 / $502.63	Professional		$284.36	$386.64	$502.63
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $84.17 / $110.21 / $143.27	Professional	26	$84.17	$110.21	$143.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $200.19 / $276.43 / $353.39	Professional	TC	$200.19	$276.43	$353.39