Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.25 / $499.57 / $961.68	Professional		$217.25	$499.57	$961.68
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $102.39 / $164.00 / $416.38	Professional	26	$102.39	$164.00	$416.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $114.86 / $307.82 / $521.57	Professional	TC	$114.86	$307.82	$521.57
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $364.61 / $364.61 / $441.18	Professional		$364.61	$364.61	$441.18
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $193.04 / $193.04 / $233.58	Professional	26	$193.04	$193.04	$233.58
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $171.57 / $171.57 / $207.60	Professional	TC	$171.57	$171.57	$207.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $326.16 / $326.16 / $326.16	Professional		$326.16	$326.16	$326.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $153.56 / $153.56 / $153.56	Professional	26	$153.56	$153.56	$153.56
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $172.60 / $172.60 / $172.60	Professional	TC	$172.60	$172.60	$172.60
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $376.09 / $451.31 / $589.85	Professional		$376.09	$451.31	$589.85
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $173.55 / $208.26 / $265.64	Professional	26	$173.55	$208.26	$265.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $202.54 / $243.05 / $310.32	Professional	TC	$202.54	$243.05	$310.32
United Facility/Professional Professional Modifier Low / Median / High Price $241.58 / $388.94 / $794.19	Professional		$241.58	$388.94	$794.19
United Facility/Professional Professional Modifier 26 Low / Median / High Price $115.90 / $147.80 / $358.52	Professional	26	$115.90	$147.80	$358.52
United Facility/Professional Professional Modifier TC Low / Median / High Price $119.02 / $207.41 / $436.61	Professional	TC	$119.02	$207.41	$436.61
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $467.81 / $528.83 / $539.40	Professional		$467.81	$528.83	$539.40
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $210.68 / $238.16 / $253.56	Professional	26	$210.68	$238.16	$253.56
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $257.14 / $285.83 / $290.68	Professional	TC	$257.14	$285.83	$290.68