Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.73 / $97.73 / $97.73	Facility	26	$97.73	$97.73	$97.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $191.78 / $233.54 / $659.46	Professional		$191.78	$233.54	$659.46
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.73 / $106.37 / $261.91	Professional	26	$97.73	$106.37	$261.91
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $94.05 / $111.20 / $252.05	Professional	TC	$94.05	$111.20	$252.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $518.07 / $518.07 / $657.95	Professional		$518.07	$518.07	$657.95
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $124.97 / $124.97 / $158.71	Professional	26	$124.97	$124.97	$158.71
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $393.10 / $393.10 / $458.06	Professional	TC	$393.10	$393.10	$458.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $340.80 / $561.52 / $1,138.19	Professional		$340.80	$561.52	$1,138.19
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.64 / $129.05 / $248.36	Professional	26	$87.64	$129.05	$248.36
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.15 / $416.87 / $838.34	Professional	TC	$253.15	$416.87	$838.34
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $363.94 / $509.07 / $828.43	Professional		$363.94	$509.07	$828.43
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $113.28 / $133.01 / $186.97	Professional	26	$113.28	$133.01	$186.97
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $230.92 / $378.92 / $641.46	Professional	TC	$230.92	$378.92	$641.46
United Facility/Professional Professional Modifier Low / Median / High Price $240.07 / $485.04 / $925.73	Professional		$240.07	$485.04	$925.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $57.02 / $117.98 / $200.92	Professional	26	$57.02	$117.98	$200.92
United Facility/Professional Professional Modifier TC Low / Median / High Price $173.95 / $362.34 / $627.00	Professional	TC	$173.95	$362.34	$627.00
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $183.86 / $247.36 / $321.57	Professional		$183.86	$247.36	$321.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $92.02 / $120.51 / $156.66	Professional	26	$92.02	$120.51	$156.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $91.84 / $126.84 / $162.16	Professional	TC	$91.84	$126.84	$162.16