Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $149.26 / $209.81 / $661.23	Professional		$149.26	$209.81	$661.23
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $21.97 / $25.76 / $69.14	Professional	26	$21.97	$25.76	$69.14
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $127.29 / $178.38 / $592.09	Professional	TC	$127.29	$178.38	$592.09
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $187.90 / $208.77 / $304.80	Professional		$187.90	$208.77	$304.80
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.32 / $24.80 / $36.21	Professional	26	$22.32	$24.80	$36.21
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $165.58 / $183.98 / $268.61	Professional	TC	$165.58	$183.98	$268.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.22 / $233.88 / $361.08	Professional		$153.22	$233.88	$361.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.02 / $32.52 / $51.91	Professional	26	$22.02	$32.52	$51.91
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $132.55 / $209.02 / $311.08	Professional	TC	$132.55	$209.02	$311.08
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $214.13 / $299.02	Professional		$165.99	$214.13	$299.02
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $23.84 / $30.28 / $48.22	Professional	26	$23.84	$30.28	$48.22
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $183.36 / $259.27	Professional	TC	$142.13	$183.36	$259.27
United Facility/Professional Professional Modifier Low / Median / High Price $145.49 / $211.56 / $408.43	Professional		$145.49	$211.56	$408.43
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.48 / $28.42 / $60.01	Professional	26	$19.48	$28.42	$60.01
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.06 / $183.90 / $294.63	Professional	TC	$124.06	$183.90	$294.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.99 / $190.89 / $236.17	Professional		$165.99	$190.89	$236.17
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $23.84 / $27.42 / $34.31	Professional	26	$23.84	$27.42	$34.31
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $142.13 / $163.46 / $203.97	Professional	TC	$142.13	$163.46	$203.97