Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.27 / $127.07 / $320.77	Professional		$95.27	$127.07	$320.77
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.79 / $29.26 / $56.48	Professional	26	$22.79	$29.26	$56.48
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $65.98 / $100.23 / $264.27	Professional	TC	$65.98	$100.23	$264.27
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $150.59 / $199.30 / $290.98	Professional		$150.59	$199.30	$290.98
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $27.10 / $30.05 / $43.87	Professional	26	$27.10	$30.05	$43.87
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $118.95 / $169.25 / $247.10	Professional	TC	$118.95	$169.25	$247.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $149.10 / $221.00 / $362.05	Professional		$149.10	$221.00	$362.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.46 / $37.72 / $57.01	Professional	26	$25.46	$37.72	$57.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $123.58 / $195.17 / $313.01	Professional	TC	$123.58	$195.17	$313.01
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $167.50 / $216.08 / $305.32	Professional		$167.50	$216.08	$305.32
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $35.77 / $42.25 / $53.84	Professional	26	$35.77	$42.25	$53.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $131.61 / $169.78 / $263.07	Professional	TC	$131.61	$169.78	$263.07
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $210.57 / $425.06	Professional		$144.54	$210.57	$425.06
United Facility/Professional Professional Modifier 26 Low / Median / High Price $23.56 / $32.51 / $59.22	Professional	26	$23.56	$32.51	$59.22
United Facility/Professional Professional Modifier TC Low / Median / High Price $121.52 / $175.79 / $288.61	Professional	TC	$121.52	$175.79	$288.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $173.37 / $214.17	Professional		$109.86	$173.37	$214.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $26.16 / $41.27 / $52.04	Professional	26	$26.16	$41.27	$52.04
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $83.70 / $132.10 / $164.89	Professional	TC	$83.70	$132.10	$164.89