Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $114.82 / $257.04	Professional		$77.62	$114.82	$257.04
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $19.05 / $51.29	Professional	26	$15.85	$19.05	$51.29
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $60.26 / $93.33 / $190.55	Professional	TC	$60.26	$93.33	$190.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $17.78 / $112.20 / $128.82	Professional		$17.78	$112.20	$128.82
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $17.78 / $19.95 / $22.91	Professional	26	$17.78	$19.95	$22.91
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $56.23 / $95.50 / $114.82	Professional	TC	$56.23	$95.50	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $223.87	Professional		$66.07	$104.71	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $14.79 / $21.38 / $42.66	Professional	26	$14.79	$21.38	$42.66
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $48.98 / $87.10 / $218.78	Professional	TC	$48.98	$87.10	$218.78
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $134.90 / $186.21	Professional		$102.33	$134.90	$186.21
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $21.38 / $28.84	Professional	26	$19.05	$21.38	$28.84
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $112.20 / $158.49	Professional	TC	$87.10	$112.20	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $107.15 / $190.55	Professional		$58.88	$107.15	$190.55
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $19.50 / $33.11	Professional	26	$14.45	$19.50	$33.11
United Facility/Professional Professional Modifier TC Low / Median / High Price $40.74 / $83.18 / $158.49	Professional	TC	$40.74	$83.18	$158.49
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $138.04 / $190.55	Professional		$63.10	$138.04	$190.55
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $10.47 / $22.39 / $28.84	Professional	26	$10.47	$22.39	$28.84
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $117.49 / $162.18	Professional	TC	$52.48	$117.49	$162.18