Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $93.73 / $112.47 / $127.99	Facility	26	$93.73	$112.47	$127.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $318.05 / $475.00 / $1,032.08	Professional		$318.05	$475.00	$1,032.08
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $93.73 / $140.00 / $389.19	Professional	26	$93.73	$140.00	$389.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $224.32 / $300.14 / $598.16	Professional	TC	$224.32	$300.14	$598.16
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $595.46 / $693.59 / $875.44	Professional		$595.46	$693.59	$875.44
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $111.50 / $123.89 / $141.60	Professional	26	$111.50	$123.89	$141.60
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $465.95 / $569.70 / $723.52	Professional	TC	$465.95	$569.70	$723.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $305.02 / $500.32 / $945.49	Professional		$305.02	$500.32	$945.49
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.06 / $131.03 / $254.58	Professional	26	$85.06	$131.03	$254.58
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $216.59 / $355.21 / $666.74	Professional	TC	$216.59	$355.21	$666.74
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $358.67 / $422.51 / $678.86	Professional		$358.67	$422.51	$678.86
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $108.62 / $127.11 / $179.25	Professional	26	$108.62	$127.11	$179.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $248.09 / $297.70 / $499.61	Professional	TC	$248.09	$297.70	$499.61
United Facility/Professional Professional Modifier Low / Median / High Price $343.26 / $539.13 / $1,201.95	Professional		$343.26	$539.13	$1,201.95
United Facility/Professional Professional Modifier 26 Low / Median / High Price $42.34 / $103.68 / $192.09	Professional	26	$42.34	$103.68	$192.09
United Facility/Professional Professional Modifier TC Low / Median / High Price $250.82 / $376.23 / $911.92	Professional	TC	$250.82	$376.23	$911.92
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $287.89 / $391.21 / $508.57	Professional		$287.89	$391.21	$508.57
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $88.26 / $115.55 / $150.22	Professional	26	$88.26	$115.55	$150.22
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $199.63 / $275.66 / $352.41	Professional	TC	$199.63	$275.66	$352.41