Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $206.63 / $275.51 / $676.03	Professional		$206.63	$275.51	$676.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.17 / $49.28 / $132.57	Professional	26	$41.17	$49.28	$132.57
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $162.49 / $233.28 / $564.53	Professional	TC	$162.49	$233.28	$564.53
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $209.22 / $276.23 / $403.30	Professional		$209.22	$276.23	$403.30
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $40.98 / $45.54 / $66.48	Professional	26	$40.98	$45.54	$66.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $163.68 / $230.70 / $336.82	Professional	TC	$163.68	$230.70	$336.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $246.86 / $373.73 / $623.39	Professional		$246.86	$373.73	$623.39
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.23 / $60.52 / $99.60	Professional	26	$42.23	$60.52	$99.60
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $203.39 / $326.52 / $548.71	Professional	TC	$203.39	$326.52	$548.71
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $266.63 / $343.95 / $506.39	Professional		$266.63	$343.95	$506.39
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $45.34 / $57.58 / $82.34	Professional	26	$45.34	$57.58	$82.34
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $221.30 / $281.05 / $429.36	Professional	TC	$221.30	$281.05	$429.36
United Facility/Professional Professional Modifier Low / Median / High Price $242.10 / $336.34 / $536.14	Professional		$242.10	$336.34	$536.14
United Facility/Professional Professional Modifier 26 Low / Median / High Price $37.77 / $53.02 / $107.13	Professional	26	$37.77	$53.02	$107.13
United Facility/Professional Professional Modifier TC Low / Median / High Price $196.75 / $282.87 / $477.07	Professional	TC	$196.75	$282.87	$477.07
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $216.03 / $306.62 / $379.77	Professional		$216.03	$306.62	$379.77
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.72 / $52.14 / $65.80	Professional	26	$36.72	$52.14	$65.80
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $179.30 / $254.50 / $317.76	Professional	TC	$179.30	$254.50	$317.76