Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $251.19 / $436.52	Professional		$199.53	$251.19	$436.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.02 / $63.10	Professional	26	$32.36	$38.02	$63.10
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $158.49 / $218.78 / $380.19	Professional	TC	$158.49	$218.78	$380.19
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $251.19 / $302.00	Professional		$34.67	$251.19	$302.00
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $32.36 / $38.90 / $47.86	Professional	26	$32.36	$38.90	$47.86
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $218.78 / $239.88 / $239.88	Professional	TC	$218.78	$239.88	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $3.80 / $186.21 / $467.74	Professional		$3.80	$186.21	$467.74
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.48 / $24.55 / $70.79	Professional	26	$0.48	$24.55	$70.79
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $3.31 / $158.49 / $398.11	Professional	TC	$3.31	$158.49	$398.11
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $338.84 / $457.09	Professional		$281.84	$338.84	$457.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $61.66	Professional	26	$40.74	$48.98	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $295.12 / $398.11	Professional	TC	$245.47	$295.12	$398.11
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $275.42 / $457.09	Professional		$144.54	$275.42	$457.09
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $37.15 / $70.79	Professional	26	$28.84	$37.15	$70.79
United Facility/Professional Professional Modifier TC Low / Median / High Price $114.82 / $239.88 / $389.05	Professional	TC	$114.82	$239.88	$389.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $398.11 / $501.19	Professional		$288.40	$398.11	$501.19
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $38.02 / $54.95 / $63.10	Professional	26	$38.02	$54.95	$63.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $245.47 / $346.74 / $436.52	Professional	TC	$245.47	$346.74	$436.52