Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $89.13 / $457.09	Professional		$69.18	$89.13	$457.09
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.85 / $30.90 / $141.25	Professional	26	$15.85	$30.90	$141.25
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $69.18 / $169.82	Professional	TC	$52.48	$69.18	$169.82
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $11.48 / $75.86 / $95.50	Professional		$11.48	$75.86	$95.50
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $16.22 / $18.20 / $23.99	Professional	26	$16.22	$18.20	$23.99
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $69.18 / $79.43	Professional	TC	$61.66	$69.18	$79.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.07 / $47.86 / $144.54	Professional		$1.07	$47.86	$144.54
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.24 / $12.02 / $34.67	Professional	26	$0.24	$12.02	$34.67
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.83 / $37.15 / $131.83	Professional	TC	$0.83	$37.15	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $100.00 / $141.25	Professional		$87.10	$100.00	$141.25
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $22.91 / $41.69	Professional	26	$19.50	$22.91	$41.69
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $67.61 / $77.62 / $109.65	Professional	TC	$67.61	$77.62	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $79.43 / $165.96	Professional		$61.66	$79.43	$165.96
United Facility/Professional Professional Modifier 26 Low / Median / High Price $14.45 / $18.62 / $33.88	Professional	26	$14.45	$18.62	$33.88
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $60.26 / $123.03	Professional	TC	$47.86	$60.26	$123.03
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $147.91	Professional		$81.28	$123.03	$147.91
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $26.30 / $30.20	Professional	26	$19.50	$26.30	$30.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $61.66 / $95.50 / $117.49	Professional	TC	$61.66	$95.50	$117.49