Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.46 / $78.16 / $114.36	Facility	26	$57.46	$78.16	$114.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $397.67 / $463.49 / $550.14	Professional		$397.67	$463.49	$550.14
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.47 / $64.28 / $143.86	Professional	26	$57.47	$64.28	$143.86
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $340.21 / $399.20 / $476.60	Professional	TC	$340.21	$399.20	$476.60
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $562.12 / $610.98 / $665.97	Professional		$562.12	$610.98	$665.97
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $79.00 / $80.77 / $88.04	Professional	26	$79.00	$80.77	$88.04
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $483.12 / $530.21 / $577.92	Professional	TC	$483.12	$530.21	$577.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $418.68 / $771.03 / $1,668.63	Professional		$418.68	$771.03	$1,668.63
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.48 / $76.26 / $175.56	Professional	26	$51.48	$76.26	$175.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $416.29 / $673.78 / $1,434.01	Professional	TC	$416.29	$673.78	$1,434.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $418.68 / $523.82 / $970.04	Professional		$418.68	$523.82	$970.04
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $63.62 / $77.20 / $140.36	Professional	26	$63.62	$77.20	$140.36
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $353.55 / $448.02 / $829.66	Professional	TC	$353.55	$448.02	$829.66
United Facility/Professional Professional Modifier Low / Median / High Price $381.21 / $513.54 / $897.08	Professional		$381.21	$513.54	$897.08
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.32 / $66.91 / $125.46	Professional	26	$53.32	$66.91	$125.46
United Facility/Professional Professional Modifier TC Low / Median / High Price $316.88 / $434.16 / $839.82	Professional	TC	$316.88	$434.16	$839.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.03 / $439.75 / $628.02	Professional		$354.03	$439.75	$628.02
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $53.58 / $66.53 / $91.23	Professional	26	$53.58	$66.53	$91.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $300.45 / $373.22 / $530.33	Professional	TC	$300.45	$373.22	$530.33