Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $229.09 / $812.83	Professional		$181.97	$229.09	$812.83
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $28.18 / $50.12 / $102.33	Professional	26	$28.18	$50.12	$102.33
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $144.54 / $177.83 / $446.68	Professional	TC	$144.54	$177.83	$446.68
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $35.48 / $199.53 / $239.88	Professional		$35.48	$199.53	$239.88
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $22.91 / $39.81 / $44.67	Professional	26	$22.91	$39.81	$44.67
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $186.21 / $204.17	Professional	TC	$165.96	$186.21	$204.17
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $61.66 / $61.66 / $61.66	Facility	26	$61.66	$61.66	$61.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $457.09	Professional		$190.55	$263.03	$457.09
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $23.44 / $38.90 / $83.18	Professional	26	$23.44	$38.90	$83.18
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $154.88 / $234.42 / $389.05	Professional	TC	$154.88	$234.42	$389.05
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $245.47 / $346.74	Professional		$194.98	$245.47	$346.74
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.11 / $43.65 / $63.10	Professional	26	$33.11	$43.65	$63.10
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $165.96 / $199.53 / $288.40	Professional	TC	$165.96	$199.53	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $257.04 / $436.52	Professional		$181.97	$257.04	$436.52
United Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $38.02 / $77.62	Professional	26	$19.50	$38.02	$77.62
United Facility/Professional Professional Modifier TC Low / Median / High Price $147.91 / $218.78 / $354.81	Professional	TC	$147.91	$218.78	$354.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $263.03 / $309.03	Professional		$165.96	$263.03	$309.03
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $30.90 / $46.77 / $56.23	Professional	26	$30.90	$46.77	$56.23
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $134.90 / $218.78 / $257.04	Professional	TC	$134.90	$218.78	$257.04