Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $468.94 / $782.04 / $1,024.33	Facility		$468.94	$782.04	$1,024.33
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $23.26 / $24.33 / $27.08	Facility	26	$23.26	$24.33	$27.08
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $113.23 / $394.85 / $842.52	Facility	TC	$113.23	$394.85	$842.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $126.53 / $521.00	Professional		$23.63	$126.53	$521.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.64 / $25.67 / $93.00	Professional	26	$19.64	$25.67	$93.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $93.58 / $106.95 / $273.94	Professional	TC	$93.58	$106.95	$273.94
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $113.00 / $125.56 / $183.32	Professional		$113.00	$125.56	$183.32
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.22 / $21.35 / $31.17	Professional	26	$19.22	$21.35	$31.17
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $93.78 / $104.21 / $152.15	Professional	TC	$93.78	$104.21	$152.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $152.77 / $152.77 / $152.77	Facility		$152.77	$152.77	$152.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.02 / $174.35 / $268.00	Professional		$114.02	$174.35	$268.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.55 / $28.68 / $46.13	Professional	26	$19.55	$28.68	$46.13
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $94.97 / $150.63 / $226.99	Professional	TC	$94.97	$150.63	$226.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $122.97 / $158.63 / $224.21	Professional		$122.97	$158.63	$224.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $21.00 / $26.67 / $39.39	Professional	26	$21.00	$26.67	$39.39
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $101.97 / $131.54 / $188.44	Professional	TC	$101.97	$131.54	$188.44
United Facility/Professional Professional Modifier Low / Median / High Price $112.15 / $155.47 / $256.73	Professional		$112.15	$155.47	$256.73
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.59 / $25.14 / $52.49	Professional	26	$17.59	$25.14	$52.49
United Facility/Professional Professional Modifier TC Low / Median / High Price $90.09 / $141.09 / $268.13	Professional	TC	$90.09	$141.09	$268.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.20 / $141.41 / $174.84	Professional		$96.20	$141.41	$174.84
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $16.43 / $24.15 / $30.42	Professional	26	$16.43	$24.15	$30.42
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $79.77 / $117.27 / $146.34	Professional	TC	$79.77	$117.27	$146.34