Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.18 / $83.18 / $83.18	Facility	26	$83.18	$83.18	$83.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $933.25 / $3,715.35	Professional		$724.44	$933.25	$3,715.35
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $79.43 / $109.65 / $363.08	Professional	26	$79.43	$109.65	$363.08
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $851.14 / $1,819.70	Professional	TC	$645.65	$851.14	$1,819.70
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $812.83 / $912.01 / $1,096.48	Professional		$812.83	$912.01	$1,096.48
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $91.20 / $100.00 / $114.82	Professional	26	$91.20	$100.00	$114.82
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $812.83 / $851.14	Professional	TC	$741.31	$812.83	$851.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $1,348.96 / $2,238.72	Professional		$794.33	$1,348.96	$2,238.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $74.13 / $107.15 / $194.98	Professional	26	$74.13	$107.15	$194.98
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $794.33 / $1,202.26 / $2,818.38	Professional	TC	$794.33	$1,202.26	$2,818.38
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $794.33 / $933.25 / $1,737.80	Professional		$794.33	$933.25	$1,737.80
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $107.15 / $165.96	Professional	26	$93.33	$107.15	$165.96
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $707.95 / $831.76 / $1,584.89	Professional	TC	$707.95	$831.76	$1,584.89
United Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $954.99 / $1,949.84	Professional		$724.44	$954.99	$1,949.84
United Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $95.50 / $199.53	Professional	26	$75.86	$95.50	$199.53
United Facility/Professional Professional Modifier TC Low / Median / High Price $645.65 / $851.14 / $1,737.80	Professional	TC	$645.65	$851.14	$1,737.80
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $831.76 / $977.24 / $1,348.96	Professional		$831.76	$977.24	$1,348.96
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $95.50 / $112.20 / $144.54	Professional	26	$95.50	$112.20	$144.54
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $741.31 / $851.14 / $1,202.26	Professional	TC	$741.31	$851.14	$1,202.26