Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $292.43 / $351.41 / $508.81	Professional		$292.43	$351.41	$508.81
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $152.80 / $180.32 / $244.23	Professional	52	$152.80	$180.32	$244.23
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $251.25 / $305.67 / $428.38	Professional	TC	$251.25	$305.67	$428.38
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $279.36 / $364.67 / $455.84	Professional		$279.36	$364.67	$455.84
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $254.22 / $323.43 / $404.29	Professional	TC	$254.22	$323.43	$404.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.60 / $434.86 / $953.83	Professional		$117.60	$434.86	$953.83
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $291.77 / $428.91 / $839.77	Professional	TC	$291.77	$428.91	$839.77
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $291.36 / $427.33 / $582.72	Professional		$291.36	$427.33	$582.72
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $33.79 / $49.57 / $67.59	Professional	26	$33.79	$49.57	$67.59
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $257.57 / $379.37 / $515.13	Professional	TC	$257.57	$379.37	$515.13
United Facility/Professional Professional Modifier Low / Median / High Price $270.56 / $375.97 / $689.24	Professional		$270.56	$375.97	$689.24
United Facility/Professional Professional Modifier TC Low / Median / High Price $211.45 / $323.95 / $594.13	Professional	TC	$211.45	$323.95	$594.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $274.83 / $440.24 / $550.30	Professional		$274.83	$440.24	$550.30
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $242.96 / $388.00 / $485.00	Professional	TC	$242.96	$388.00	$485.00