Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $193.59 / $265.29 / $385.24	Facility	26	$193.59	$265.29	$385.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $420.48 / $504.96 / $2,602.54	Professional		$420.48	$504.96	$2,602.54
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $193.59 / $241.57 / $639.02	Professional	26	$193.59	$241.57	$639.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $226.89 / $306.66 / $608.05	Professional	TC	$226.89	$306.66	$608.05
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $484.38 / $496.13 / $1,452.89	Professional		$484.38	$496.13	$1,452.89
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $243.62 / $244.63 / $310.68	Professional	26	$243.62	$244.63	$310.68
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $251.50 / $251.50 / $1,209.28	Professional	TC	$251.50	$251.50	$1,209.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $388.68 / $718.11 / $1,369.28	Professional		$388.68	$718.11	$1,369.28
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $178.43 / $268.55 / $597.33	Professional	26	$178.43	$268.55	$597.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $210.24 / $360.76 / $854.46	Professional	TC	$210.24	$360.76	$854.46
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $502.49 / $648.21 / $1,106.58	Professional		$502.49	$648.21	$1,106.58
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $230.68 / $297.58 / $442.72	Professional	26	$230.68	$297.58	$442.72
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $271.81 / $353.35 / $622.53	Professional	TC	$271.81	$353.35	$622.53
United Facility/Professional Professional Modifier Low / Median / High Price $429.00 / $643.50 / $1,293.35	Professional		$429.00	$643.50	$1,293.35
United Facility/Professional Professional Modifier 26 Low / Median / High Price $164.18 / $244.95 / $407.23	Professional	26	$164.18	$244.95	$407.23
United Facility/Professional Professional Modifier TC Low / Median / High Price $233.04 / $359.89 / $1,089.26	Professional	TC	$233.04	$359.89	$1,089.26
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $483.71 / $574.32 / $706.72	Professional		$483.71	$574.32	$706.72
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $222.07 / $265.27 / $316.82	Professional	26	$222.07	$265.27	$316.82
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $261.64 / $306.70 / $389.90	Professional	TC	$261.64	$306.70	$389.90