Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $52.14 / $52.14 / $65.77	Facility	26	$52.14	$52.14	$65.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $382.41 / $428.95 / $804.71	Professional		$382.41	$428.95	$804.71
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.71 / $59.50 / $122.29	Professional	26	$51.71	$59.50	$122.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $320.08 / $369.51 / $687.28	Professional	TC	$320.08	$369.51	$687.28
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $441.28 / $490.31 / $654.29	Professional		$441.28	$490.31	$654.29
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $56.55 / $62.84 / $83.03	Professional	26	$56.55	$62.84	$83.03
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $384.72 / $427.47 / $571.26	Professional	TC	$384.72	$427.47	$571.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $394.85 / $629.11 / $1,091.52	Professional		$394.85	$629.11	$1,091.52
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $49.98 / $86.10 / $144.30	Professional	26	$49.98	$86.10	$144.30
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $340.68 / $545.07 / $948.26	Professional	TC	$340.68	$545.07	$948.26
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $343.43 / $503.69 / $686.85	Professional		$343.43	$503.69	$686.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $42.47 / $62.48 / $84.95	Professional	26	$42.47	$62.48	$84.95
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $300.95 / $442.53 / $601.91	Professional	TC	$300.95	$442.53	$601.91
United Facility/Professional Professional Modifier Low / Median / High Price $344.67 / $524.11 / $875.56	Professional		$344.67	$524.11	$875.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $48.26 / $72.65 / $121.87	Professional	26	$48.26	$72.65	$121.87
United Facility/Professional Professional Modifier TC Low / Median / High Price $292.13 / $448.66 / $725.33	Professional	TC	$292.13	$448.66	$725.33
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $420.39 / $518.52 / $648.15	Professional		$420.39	$518.52	$648.15
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.00 / $65.12 / $82.50	Professional	26	$52.00	$65.12	$82.50
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $368.39 / $452.52 / $565.65	Professional	TC	$368.39	$452.52	$565.65