Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $245.54 / $339.86 / $382.29	Professional		$245.54	$339.86	$382.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $30.50 / $38.07 / $39.19	Professional	26	$30.50	$38.07	$39.19
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $215.05 / $303.17 / $541.15	Professional	TC	$215.05	$303.17	$541.15
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $423.55 / $482.98 / $603.73	Professional		$423.55	$482.98	$603.73
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.83 / $42.56 / $53.20	Professional	26	$40.83	$42.56	$53.20
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $389.07 / $440.42 / $559.33	Professional	TC	$389.07	$440.42	$559.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.42 / $284.70 / $788.77	Professional		$166.42	$284.70	$788.77
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $19.46 / $26.65 / $77.77	Professional	26	$19.46	$26.65	$77.77
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $146.94 / $257.35 / $703.29	Professional	TC	$146.94	$257.35	$703.29
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $422.44 / $506.93 / $673.47	Professional		$422.44	$506.93	$673.47
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $47.44 / $56.93 / $72.47	Professional	26	$47.44	$56.93	$72.47
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $375.00 / $450.00 / $600.98	Professional	TC	$375.00	$450.00	$600.98
United Facility/Professional Professional Modifier Low / Median / High Price $270.24 / $394.38 / $839.83	Professional		$270.24	$394.38	$839.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $31.40 / $40.71 / $76.34	Professional	26	$31.40	$40.71	$76.34
United Facility/Professional Professional Modifier TC Low / Median / High Price $239.71 / $350.03 / $719.12	Professional	TC	$239.71	$350.03	$719.12
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $423.21 / $534.13 / $603.79	Professional		$423.21	$534.13	$603.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $42.62 / $57.48 / $69.27	Professional	26	$42.62	$57.48	$69.27
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $380.64 / $476.64 / $538.80	Professional	TC	$380.64	$476.64	$538.80