Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $366.97 / $407.60 / $563.95	Professional		$366.97	$407.60	$563.95
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $53.19 / $61.01 / $79.52	Professional	26	$53.19	$61.01	$79.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $183.49 / $195.31 / $270.75	Professional	52	$183.49	$195.31	$270.75
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $308.37 / $346.84 / $480.57	Professional	TC	$308.37	$346.84	$480.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $473.76 / $491.58 / $594.80	Professional		$473.76	$491.58	$594.80
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $59.87 / $66.52 / $80.48	Professional	26	$59.87	$66.52	$80.48
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $402.60 / $425.06 / $514.90	Professional	TC	$402.60	$425.06	$514.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $372.40 / $623.54 / $1,018.95	Professional		$372.40	$623.54	$1,018.95
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.31 / $85.52 / $149.37	Professional	26	$51.31	$85.52	$149.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $317.23 / $545.34 / $864.93	Professional	TC	$317.23	$545.34	$864.93
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $323.89 / $496.65 / $650.92	Professional		$323.89	$496.65	$650.92
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $43.67 / $64.13 / $87.33	Professional	26	$43.67	$64.13	$87.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $280.24 / $429.70 / $565.54	Professional	TC	$280.24	$429.70	$565.54
United Facility/Professional Professional Modifier Low / Median / High Price $349.06 / $513.61 / $800.64	Professional		$349.06	$513.61	$800.64
United Facility/Professional Professional Modifier 26 Low / Median / High Price $53.08 / $73.50 / $116.68	Professional	26	$53.08	$73.50	$116.68
United Facility/Professional Professional Modifier TC Low / Median / High Price $308.45 / $435.70 / $794.29	Professional	TC	$308.45	$435.70	$794.29
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $414.95 / $489.34 / $611.66	Professional		$414.95	$489.34	$611.66
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $55.94 / $66.95 / $84.95	Professional	26	$55.94	$66.95	$84.95
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $359.01 / $421.38 / $526.72	Professional	TC	$359.01	$421.38	$526.72