Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $240.48 / $282.82 / $408.69	Professional		$240.48	$282.82	$408.69
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $90.56 / $99.27 / $129.97	Professional	26	$90.56	$99.27	$129.97
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $146.69 / $181.44 / $289.23	Professional	TC	$146.69	$181.44	$289.23
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $259.00 / $287.77 / $445.81	Professional		$259.00	$287.77	$445.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $94.68 / $105.20 / $131.50	Professional	26	$94.68	$105.20	$131.50
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $164.32 / $182.58 / $346.79	Professional	TC	$164.32	$182.58	$346.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $233.55 / $419.37 / $774.72	Professional		$233.55	$419.37	$774.72
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $89.21 / $142.16 / $255.27	Professional	26	$89.21	$142.16	$255.27
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $144.50 / $266.95 / $539.85	Professional	TC	$144.50	$266.95	$539.85
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $225.62 / $330.90 / $451.23	Professional		$225.62	$330.90	$451.23
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $75.54 / $110.79 / $151.08	Professional	26	$75.54	$110.79	$151.08
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $143.59 / $220.90 / $300.14	Professional	TC	$143.59	$220.90	$300.14
United Facility/Professional Professional Modifier Low / Median / High Price $198.44 / $298.67 / $581.11	Professional		$198.44	$298.67	$581.11
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.80 / $107.42 / $197.16	Professional	26	$79.80	$107.42	$197.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $124.25 / $191.16 / $386.05	Professional	TC	$124.25	$191.16	$386.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $243.01 / $343.01 / $428.76	Professional		$243.01	$343.01	$428.76
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $81.36 / $115.83 / $146.37	Professional	26	$81.36	$115.83	$146.37
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $161.65 / $225.91 / $282.39	Professional	TC	$161.65	$225.91	$282.39