Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $371.54 / $446.68 / $1,023.29	Professional		$371.54	$446.68	$1,023.29
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $72.44 / $245.47	Professional	26	$52.48	$72.44	$245.47
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $323.59 / $380.19 / $758.58	Professional	TC	$323.59	$380.19	$758.58
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $501.19 / $616.60	Professional		$56.23	$501.19	$616.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $63.10 / $63.10 / $83.18	Professional	26	$63.10	$63.10	$83.18
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $416.87 / $467.74 / $575.44	Professional	TC	$416.87	$467.74	$575.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $407.38 / $588.84 / $1,047.13	Professional		$407.38	$588.84	$1,047.13
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $81.28 / $144.54	Professional	26	$51.29	$81.28	$144.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $346.74 / $524.81 / $954.99	Professional	TC	$346.74	$524.81	$954.99
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $389.05 / $562.34 / $776.25	Professional		$389.05	$562.34	$776.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $44.67 / $64.57 / $89.13	Professional	26	$44.67	$64.57	$89.13
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $338.84 / $501.19 / $676.08	Professional	TC	$338.84	$501.19	$676.08
United Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $537.03 / $954.99	Professional		$354.81	$537.03	$954.99
United Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $77.62 / $125.89	Professional	26	$51.29	$77.62	$125.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $302.00 / $457.09 / $812.83	Professional	TC	$302.00	$457.09	$812.83
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $588.84 / $724.44	Professional		$416.87	$588.84	$724.44
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $52.48 / $69.18 / $87.10	Professional	26	$52.48	$69.18	$87.10
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $371.54 / $524.81 / $645.65	Professional	TC	$371.54	$524.81	$645.65