Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $389.05 / $1,071.52	Professional		$302.00	$389.05	$1,071.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $302.00 / $794.33	Professional	26	$112.20	$302.00	$794.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $204.17 / $269.15 / $602.56	Professional	TC	$204.17	$269.15	$602.56
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $338.84 / $446.68	Professional		$134.90	$338.84	$446.68
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $112.20 / $131.83 / $295.12	Professional	26	$112.20	$131.83	$295.12
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $295.12 / $309.03	Professional	TC	$74.13	$295.12	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $4.79 / $234.42 / $562.34	Professional		$4.79	$234.42	$562.34
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $1.62 / $77.62 / $229.09	Professional	26	$1.62	$77.62	$229.09
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.31 / $158.49 / $489.78	Professional	TC	$3.31	$158.49	$489.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $436.52 / $501.19 / $691.83	Professional		$436.52	$501.19	$691.83
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $138.04 / $165.96 / $229.09	Professional	26	$138.04	$165.96	$229.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $295.12 / $346.74 / $478.63	Professional	TC	$295.12	$346.74	$478.63
United Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $338.84 / $691.83	Professional		$218.78	$338.84	$691.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $89.13 / $123.03 / $245.47	Professional	26	$89.13	$123.03	$245.47
United Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $218.78 / $416.87	Professional	TC	$144.54	$218.78	$416.87
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $616.60 / $707.95	Professional		$354.81	$616.60	$707.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $128.82 / $190.55 / $213.80	Professional	26	$128.82	$190.55	$213.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $229.09 / $426.58 / $489.78	Professional	TC	$229.09	$426.58	$489.78