Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $98.93 / $126.00 / $151.19	Facility	26	$98.93	$126.00	$151.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $400.00 / $475.00 / $1,374.36	Professional		$400.00	$475.00	$1,374.36
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.29 / $129.26 / $337.68	Professional	26	$89.29	$129.26	$337.68
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $281.41 / $335.00 / $801.32	Professional	TC	$281.41	$335.00	$801.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $476.11 / $577.20 / $655.14	Professional		$476.11	$577.20	$655.14
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $86.17 / $96.20 / $109.96	Professional	26	$86.17	$96.20	$109.96
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.94 / $481.00 / $544.29	Professional	TC	$389.94	$481.00	$544.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $303.05 / $557.79 / $947.34	Professional		$303.05	$557.79	$947.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $65.93 / $103.28 / $195.63	Professional	26	$65.93	$103.28	$195.63
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $249.89 / $439.32 / $728.28	Professional	TC	$249.89	$439.32	$728.28
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $355.08 / $458.05 / $774.48	Professional		$355.08	$458.05	$774.48
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $83.88 / $102.29 / $150.50	Professional	26	$83.88	$102.29	$150.50
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $269.83 / $348.09 / $596.02	Professional	TC	$269.83	$348.09	$596.02
United Facility/Professional Professional Modifier Low / Median / High Price $277.92 / $452.34 / $924.58	Professional		$277.92	$452.34	$924.58
United Facility/Professional Professional Modifier 26 Low / Median / High Price $52.99 / $96.18 / $168.08	Professional	26	$52.99	$96.18	$168.08
United Facility/Professional Professional Modifier TC Low / Median / High Price $215.25 / $346.54 / $723.08	Professional	TC	$215.25	$346.54	$723.08
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $284.06 / $387.24 / $503.41	Professional		$284.06	$387.24	$503.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $68.19 / $89.23 / $116.00	Professional	26	$68.19	$89.23	$116.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $215.87 / $298.01 / $380.97	Professional	TC	$215.87	$298.01	$380.97