Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $316.80 / $344.71 / $972.55	Professional		$316.80	$344.71	$972.55
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $86.15 / $91.48 / $244.28	Professional	26	$86.15	$91.48	$244.28
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $230.66 / $256.00 / $737.32	Professional	TC	$230.66	$256.00	$737.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $324.43 / $398.18 / $509.67	Professional		$324.43	$398.18	$509.67
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $89.12 / $99.03 / $130.85	Professional	26	$89.12	$99.03	$130.85
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $223.57 / $272.04 / $341.93	Professional	TC	$223.57	$272.04	$341.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $271.08 / $412.09 / $982.82	Professional		$271.08	$412.09	$982.82
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $84.71 / $121.39 / $256.83	Professional	26	$84.71	$121.39	$256.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $189.72 / $303.04 / $717.19	Professional	TC	$189.72	$303.04	$717.19
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $288.25 / $371.84 / $710.79	Professional		$288.25	$371.84	$710.79
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $85.16 / $113.26 / $182.29	Professional	26	$85.16	$113.26	$182.29
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $203.09 / $261.99 / $526.65	Professional	TC	$203.09	$261.99	$526.65
United Facility/Professional Professional Modifier Low / Median / High Price $269.91 / $389.68 / $729.88	Professional		$269.91	$389.68	$729.88
United Facility/Professional Professional Modifier 26 Low / Median / High Price $74.20 / $109.99 / $206.14	Professional	26	$74.20	$109.99	$206.14
United Facility/Professional Professional Modifier TC Low / Median / High Price $185.95 / $269.44 / $444.96	Professional	TC	$185.95	$269.44	$444.96
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $265.31 / $331.49 / $409.44	Professional		$265.31	$331.49	$409.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $78.37 / $97.93 / $122.58	Professional	26	$78.37	$97.93	$122.58
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $186.94 / $233.55 / $286.86	Professional	TC	$186.94	$233.55	$286.86