Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.04 / $57.09 / $166.03	Professional		$38.04	$57.09	$166.03
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.37 / $22.13 / $69.83	Professional	26	$17.37	$22.13	$69.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $20.67 / $34.72 / $91.55	Professional	TC	$20.67	$34.72	$91.55
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.30 / $64.62 / $82.07	Professional		$52.30	$64.62	$82.07
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $23.38 / $24.22 / $31.00	Professional	26	$23.38	$24.22	$31.00
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $23.45 / $40.39 / $51.30	Professional	TC	$23.45	$40.39	$51.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.12 / $40.53 / $103.50	Professional		$24.12	$40.53	$103.50
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.31 / $15.03 / $44.53	Professional	26	$0.31	$15.03	$44.53
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.61 / $26.14 / $58.97	Professional	TC	$0.61	$26.14	$58.97
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $82.86 / $99.08 / $124.29	Professional		$82.86	$99.08	$124.29
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $27.27 / $33.10 / $58.25	Professional	26	$27.27	$33.10	$58.25
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $55.59 / $66.70 / $83.39	Professional	TC	$55.59	$66.70	$83.39
United Facility/Professional Professional Modifier Low / Median / High Price $41.79 / $53.05 / $104.48	Professional		$41.79	$53.05	$104.48
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.80 / $23.38 / $60.28	Professional	26	$17.80	$23.38	$60.28
United Facility/Professional Professional Modifier TC Low / Median / High Price $24.17 / $33.47 / $60.63	Professional	TC	$24.17	$33.47	$60.63
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $61.08 / $103.58 / $118.14	Professional		$61.08	$103.58	$118.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $24.63 / $33.10 / $39.79	Professional	26	$24.63	$33.10	$39.79
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $36.45 / $70.48 / $79.68	Professional	TC	$36.45	$70.48	$79.68