Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $70.81 / $97.06 / $140.94	Facility	26	$70.81	$97.06	$140.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $401.84 / $522.85 / $1,367.15	Professional		$401.84	$522.85	$1,367.15
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.45 / $88.71 / $217.37	Professional	26	$68.45	$88.71	$217.37
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $331.01 / $413.91 / $1,040.22	Professional	TC	$331.01	$413.91	$1,040.22
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $615.54 / $630.47 / $825.24	Professional		$615.54	$630.47	$825.24
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.27 / $83.27 / $188.23	Professional	26	$83.27	$83.27	$188.23
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $543.76 / $547.20 / $691.88	Professional	TC	$543.76	$547.20	$691.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $354.82 / $570.36 / $1,226.97	Professional		$354.82	$570.36	$1,226.97
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $64.97 / $98.26 / $218.55	Professional	26	$64.97	$98.26	$218.55
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $289.85 / $492.38 / $1,008.42	Professional	TC	$289.85	$492.38	$1,008.42
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $458.72 / $596.34 / $3,300.00	Professional		$458.72	$596.34	$3,300.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $81.41 / $108.36 / $3,300.00	Professional	26	$81.41	$108.36	$3,300.00
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $374.72 / $489.87 / $3,300.00	Professional	TC	$374.72	$489.87	$3,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $345.85 / $508.14 / $907.60	Professional		$345.85	$508.14	$907.60
United Facility/Professional Professional Modifier 26 Low / Median / High Price $58.39 / $85.17 / $149.34	Professional	26	$58.39	$85.17	$149.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $268.93 / $413.19 / $751.38	Professional	TC	$268.93	$413.19	$751.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $414.59 / $520.97 / $653.69	Professional		$414.59	$520.97	$653.69
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.91 / $96.60 / $115.39	Professional	26	$75.91	$96.60	$115.39
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $338.68 / $423.50 / $538.29	Professional	TC	$338.68	$423.50	$538.29