Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $416.87 / $1,023.29	Professional		$338.84	$416.87	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $100.00 / $128.82 / $275.42	Professional	26	$100.00	$128.82	$275.42
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $295.12 / $676.08	Professional	TC	$229.09	$295.12	$676.08
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $363.08 / $512.86	Professional		$104.71	$363.08	$512.86
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $117.49 / $117.49 / $147.91	Professional	26	$117.49	$117.49	$147.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $257.04 / $257.04 / $501.19	Professional	TC	$257.04	$257.04	$501.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.23 / $457.09 / $1,023.29	Professional		$316.23	$457.09	$1,023.29
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $104.71 / $144.54 / $302.00	Professional	26	$104.71	$144.54	$302.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $208.93 / $323.59 / $724.44	Professional	TC	$208.93	$323.59	$724.44
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $407.38 / $691.83	Professional		$354.81	$407.38	$691.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $128.82 / $213.80	Professional	26	$112.20	$128.82	$213.80
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $239.88 / $275.42 / $501.19	Professional	TC	$239.88	$275.42	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $691.83	Professional		$288.40	$398.11	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $93.33 / $128.82 / $213.80	Professional	26	$93.33	$128.82	$213.80
United Facility/Professional Professional Modifier TC Low / Median / High Price $190.55 / $275.42 / $478.63	Professional	TC	$190.55	$275.42	$478.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $457.09 / $549.54	Professional		$251.19	$457.09	$549.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.86 / $144.54 / $158.49	Professional	26	$75.86	$144.54	$158.49
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.78 / $316.23 / $380.19	Professional	TC	$173.78	$316.23	$380.19