Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $367.59 / $409.43 / $1,097.27	Professional		$367.59	$409.43	$1,097.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $103.38 / $113.96 / $305.41	Professional	26	$103.38	$113.96	$305.41
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $247.37 / $295.47 / $791.85	Professional	TC	$247.37	$295.47	$791.85
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $398.45 / $463.33 / $615.12	Professional		$398.45	$463.33	$615.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $120.26 / $124.81 / $162.11	Professional	26	$120.26	$124.81	$162.11
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $269.45 / $327.02 / $451.79	Professional	TC	$269.45	$327.02	$451.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $314.52 / $460.54 / $1,198.56	Professional		$314.52	$460.54	$1,198.56
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $106.85 / $151.80 / $323.74	Professional	26	$106.85	$151.80	$323.74
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $222.74 / $322.48 / $862.07	Professional	TC	$222.74	$322.48	$862.07
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $353.85 / $461.12 / $865.91	Professional		$353.85	$461.12	$865.91
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $106.83 / $137.81 / $228.65	Professional	26	$106.83	$137.81	$228.65
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $247.03 / $327.56 / $633.10	Professional	TC	$247.03	$327.56	$633.10
United Facility/Professional Professional Modifier Low / Median / High Price $288.93 / $439.57 / $742.45	Professional		$288.93	$439.57	$742.45
United Facility/Professional Professional Modifier 26 Low / Median / High Price $92.76 / $131.61 / $213.38	Professional	26	$92.76	$131.61	$213.38
United Facility/Professional Professional Modifier TC Low / Median / High Price $195.47 / $293.69 / $542.83	Professional	TC	$195.47	$293.69	$542.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $248.97 / $406.93 / $502.41	Professional		$248.97	$406.93	$502.41
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $75.16 / $122.85 / $153.44	Professional	26	$75.16	$122.85	$153.44
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $173.81 / $284.08 / $348.98	Professional	TC	$173.81	$284.08	$348.98