Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.32 / $163.85 / $296.56	Professional		$153.32	$163.85	$296.56
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $54.64 / $90.52	Professional	26	$53.08	$54.64	$90.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.37 / $109.21 / $197.32	Professional	TC	$99.37	$109.21	$197.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $297.74 / $389.66 / $440.32	Professional		$297.74	$389.66	$440.32
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $60.97 / $67.73 / $76.55	Professional	26	$60.97	$67.73	$76.55
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $228.85 / $321.92 / $363.77	Professional	TC	$228.85	$321.92	$363.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $270.88 / $399.18 / $722.58	Professional		$270.88	$399.18	$722.58
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.58 / $74.70 / $127.43	Professional	26	$51.58	$74.70	$127.43
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $214.63 / $333.79 / $600.92	Professional	TC	$214.63	$333.79	$600.92
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $304.32 / $383.01 / $582.62	Professional		$304.32	$383.01	$582.62
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.54 / $73.97 / $96.93	Professional	26	$58.54	$73.97	$96.93
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $245.78 / $312.12 / $485.69	Professional	TC	$245.78	$312.12	$485.69
United Facility/Professional Professional Modifier Low / Median / High Price $237.41 / $350.80 / $836.62	Professional		$237.41	$350.80	$836.62
United Facility/Professional Professional Modifier 26 Low / Median / High Price $46.44 / $68.63 / $124.11	Professional	26	$46.44	$68.63	$124.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $182.52 / $282.44 / $547.30	Professional	TC	$182.52	$282.44	$547.30
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $136.41 / $199.42 / $247.10	Professional		$136.41	$199.42	$247.10
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $46.06 / $67.31 / $84.96	Professional	26	$46.06	$67.31	$84.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $90.36 / $132.10 / $164.89	Professional	TC	$90.36	$132.10	$164.89