Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $62.35 / $62.35 / $85.22	Facility	26	$62.35	$62.35	$85.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $342.85 / $390.57 / $686.96	Professional		$342.85	$390.57	$686.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $62.35 / $69.62 / $162.11	Professional	26	$62.35	$69.62	$162.11
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $274.27 / $317.61 / $568.49	Professional	TC	$274.27	$317.61	$568.49
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $438.49 / $438.49 / $504.26	Professional		$438.49	$438.49	$504.26
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $85.56 / $85.56 / $98.39	Professional	26	$85.56	$85.56	$98.39
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $352.93 / $352.93 / $405.87	Professional	TC	$352.93	$352.93	$405.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $313.07 / $441.17 / $1,088.76	Professional		$313.07	$441.17	$1,088.76
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $56.22 / $82.88 / $191.74	Professional	26	$56.22	$82.88	$191.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $253.70 / $374.44 / $1,203.23	Professional	TC	$253.70	$374.44	$1,203.23
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $383.16 / $478.32 / $834.29	Professional		$383.16	$478.32	$834.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $69.45 / $84.30 / $150.22	Professional	26	$69.45	$84.30	$150.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $312.14 / $395.55 / $684.07	Professional	TC	$312.14	$395.55	$684.07
United Facility/Professional Professional Modifier Low / Median / High Price $289.16 / $442.05 / $786.65	Professional		$289.16	$442.05	$786.65
United Facility/Professional Professional Modifier 26 Low / Median / High Price $60.12 / $71.76 / $133.99	Professional	26	$60.12	$71.76	$133.99
United Facility/Professional Professional Modifier TC Low / Median / High Price $244.01 / $373.05 / $678.69	Professional	TC	$244.01	$373.05	$678.69
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $323.80 / $340.81 / $574.74	Professional		$323.80	$340.81	$574.74
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $58.49 / $61.55 / $99.63	Professional	26	$58.49	$61.55	$99.63
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $265.30 / $279.23 / $468.21	Professional	TC	$265.30	$279.23	$468.21