Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $130.58 / $130.58 / $178.95	Facility	26	$130.58	$130.58	$178.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $317.47 / $402.89 / $1,055.72	Professional		$317.47	$402.89	$1,055.72
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $130.58 / $136.38 / $339.51	Professional	26	$130.58	$136.38	$339.51
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $185.65 / $272.30 / $725.66	Professional	TC	$185.65	$272.30	$725.66
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $405.28 / $405.28 / $533.57	Professional		$405.28	$405.28	$533.57
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $162.37 / $162.37 / $213.35	Professional	26	$162.37	$162.37	$213.35
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $242.91 / $242.91 / $367.35	Professional	TC	$242.91	$242.91	$367.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $364.80 / $500.26 / $1,254.64	Professional		$364.80	$500.26	$1,254.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $120.88 / $181.15 / $402.92	Professional	26	$120.88	$181.15	$402.92
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $221.80 / $317.14 / $851.72	Professional	TC	$221.80	$317.14	$851.72
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $481.51 / $621.15 / $1,008.93	Professional		$481.51	$621.15	$1,008.93
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $156.28 / $201.60 / $327.36	Professional	26	$156.28	$201.60	$327.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $325.23 / $419.55 / $681.58	Professional	TC	$325.23	$419.55	$681.58
United Facility/Professional Professional Modifier Low / Median / High Price $293.44 / $417.56 / $732.15	Professional		$293.44	$417.56	$732.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $110.22 / $160.29 / $268.43	Professional	26	$110.22	$160.29	$268.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $154.34 / $260.57 / $475.36	Professional	TC	$154.34	$260.57	$475.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $298.82 / $548.16 / $681.06	Professional		$298.82	$548.16	$681.06
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $97.00 / $179.72 / $214.47	Professional	26	$97.00	$179.72	$214.47
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $201.82 / $367.02 / $466.57	Professional	TC	$201.82	$367.02	$466.57