Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $57.54 / $57.54 / $79.43	Facility	26	$57.54	$57.54	$79.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $398.11 / $524.81 / $1,995.26	Professional		$398.11	$524.81	$1,995.26
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $57.54 / $85.11 / $257.04	Professional	26	$57.54	$85.11	$257.04
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $436.52 / $954.99	Professional	TC	$323.59	$436.52	$954.99
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $562.34	Professional		$426.58	$489.78	$562.34
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $70.79 / $75.86	Professional	26	$63.10	$70.79	$75.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $416.87 / $416.87	Professional	TC	$371.54	$416.87	$416.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $707.95 / $1,202.26	Professional		$426.58	$707.95	$1,202.26
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $75.86 / $134.90	Professional	26	$51.29	$75.86	$134.90
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $398.11 / $616.60 / $1,445.44	Professional	TC	$398.11	$616.60	$1,445.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $489.78 / $912.01	Professional		$426.58	$489.78	$912.01
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $64.57 / $74.13 / $114.82	Professional	26	$64.57	$74.13	$114.82
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $363.08 / $416.87 / $812.83	Professional	TC	$363.08	$416.87	$812.83
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $512.86 / $1,023.29	Professional		$380.19	$512.86	$1,023.29
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.70 / $67.61 / $141.25	Professional	26	$53.70	$67.61	$141.25
United Facility/Professional Professional Modifier TC Low / Median / High Price $331.13 / $436.52 / $891.25	Professional	TC	$331.13	$436.52	$891.25
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $512.86 / $707.95	Professional		$436.52	$512.86	$707.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $66.07 / $77.62 / $100.00	Professional	26	$66.07	$77.62	$100.00
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $436.52 / $602.56	Professional	TC	$371.54	$436.52	$602.56