Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $64.40 / $87.61 / $128.15	Facility	26	$64.40	$87.61	$128.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $378.65 / $433.43 / $789.73	Professional		$378.65	$433.43	$789.73
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $66.81 / $77.92 / $197.89	Professional	26	$66.81	$77.92	$197.89
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $324.75 / $365.81 / $672.62	Professional	TC	$324.75	$365.81	$672.62
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $550.74 / $550.74 / $1,299.03	Professional		$550.74	$550.74	$1,299.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $83.42 / $83.42 / $196.76	Professional	26	$83.42	$83.42	$196.76
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $467.32 / $467.32 / $897.89	Professional	TC	$467.32	$467.32	$897.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $339.26 / $564.11 / $1,230.90	Professional		$339.26	$564.11	$1,230.90
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $58.02 / $88.96 / $197.87	Professional	26	$58.02	$88.96	$197.87
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $281.18 / $521.84 / $989.21	Professional	TC	$281.18	$521.84	$989.21
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $416.68 / $528.21 / $960.38	Professional		$416.68	$528.21	$960.38
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $73.01 / $87.61 / $153.75	Professional	26	$73.01	$87.61	$153.75
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $345.33 / $441.45 / $802.64	Professional	TC	$345.33	$441.45	$802.64
United Facility/Professional Professional Modifier Low / Median / High Price $407.42 / $556.09 / $963.87	Professional		$407.42	$556.09	$963.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.67 / $95.61 / $151.83	Professional	26	$64.67	$95.61	$151.83
United Facility/Professional Professional Modifier TC Low / Median / High Price $340.40 / $448.19 / $860.38	Professional	TC	$340.40	$448.19	$860.38
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $350.89 / $390.12 / $622.54	Professional		$350.89	$390.12	$622.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $60.07 / $66.79 / $102.53	Professional	26	$60.07	$66.79	$102.53
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $290.81 / $323.33 / $513.03	Professional	TC	$290.81	$323.33	$513.03