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 / $144.54	Facility	26	$125.89	$125.89	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $602.56 / $2,398.83	Professional		$380.19	$602.56	$2,398.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $239.88 / $575.44	Professional	26	$117.49	$239.88	$575.44
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $371.54 / $870.96	Professional	TC	$257.04	$371.54	$870.96
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $457.09 / $537.03 / $741.31	Professional		$457.09	$537.03	$741.31
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $141.25 / $165.96 / $186.21	Professional	26	$141.25	$165.96	$186.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $371.54 / $426.58	Professional	TC	$331.13	$371.54	$426.58
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $199.53 / $199.53 / $199.53	Facility	26	$199.53	$199.53	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $323.59 / $602.56 / $1,096.48	Professional		$323.59	$602.56	$1,096.48
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $141.25 / $269.15	Professional	26	$93.33	$141.25	$269.15
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $223.87 / $416.87 / $776.25	Professional	TC	$223.87	$416.87	$776.25
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $436.52 / $724.44	Professional		$380.19	$436.52	$724.44
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $120.23 / $138.04 / $186.21	Professional	26	$120.23	$138.04	$186.21
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $263.03 / $295.12 / $549.54	Professional	TC	$263.03	$295.12	$549.54
United Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $512.86 / $912.01	Professional		$338.84	$512.86	$912.01
United Facility/Professional Professional Modifier 26 Low / Median / High Price $72.44 / $128.82 / $218.78	Professional	26	$72.44	$128.82	$218.78
United Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $380.19 / $691.83	Professional	TC	$245.47	$380.19	$691.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $446.68 / $602.56	Professional		$380.19	$446.68	$602.56
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $123.03 / $144.54 / $186.21	Professional	26	$123.03	$144.54	$186.21
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $302.00 / $416.87	Professional	TC	$257.04	$302.00	$416.87