Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.88 / $319.88 / $857.27	Professional		$134.88	$319.88	$857.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.21 / $51.46 / $129.36	Professional	26	$42.21	$51.46	$129.36
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $92.67 / $271.60 / $727.88	Professional	TC	$92.67	$271.60	$727.88
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $366.74 / $392.69 / $485.03	Professional		$366.74	$392.69	$485.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $62.94 / $69.93 / $88.81	Professional	26	$62.94	$69.93	$88.81
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $305.82 / $322.76 / $398.65	Professional	TC	$305.82	$322.76	$398.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.70 / $222.85 / $490.14	Professional		$91.70	$222.85	$490.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $27.12 / $35.07 / $97.51	Professional	26	$27.12	$35.07	$97.51
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $64.54 / $180.58 / $418.51	Professional	TC	$64.54	$180.58	$418.51
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $403.20 / $483.84 / $641.29	Professional		$403.20	$483.84	$641.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $62.65 / $75.18 / $95.67	Professional	26	$62.65	$75.18	$95.67
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $340.55 / $408.66 / $545.62	Professional	TC	$340.55	$408.66	$545.62
United Facility/Professional Professional Modifier Low / Median / High Price $150.74 / $329.42 / $617.66	Professional		$150.74	$329.42	$617.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $41.81 / $53.99 / $121.48	Professional	26	$41.81	$53.99	$121.48
United Facility/Professional Professional Modifier TC Low / Median / High Price $102.42 / $273.27 / $516.42	Professional	TC	$102.42	$273.27	$516.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $340.24 / $508.61 / $574.95	Professional		$340.24	$508.61	$574.95
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.56 / $75.88 / $91.89	Professional	26	$55.56	$75.88	$91.89
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $284.68 / $432.73 / $489.18	Professional	TC	$284.68	$432.73	$489.18