Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $88.01 / $96.95 / $362.53	Professional		$88.01	$96.95	$362.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $54.17 / $71.03 / $177.95	Professional	26	$54.17	$71.03	$177.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.62 / $33.88 / $62.72	Professional	TC	$19.62	$33.88	$62.72
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $104.00 / $122.93 / $156.12	Professional		$104.00	$122.93	$156.12
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $81.11 / $95.88 / $136.93	Professional	26	$81.11	$95.88	$136.93
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $22.88 / $27.05 / $34.35	Professional	TC	$22.88	$27.05	$34.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.22 / $70.03 / $226.64	Professional		$50.22	$70.03	$226.64
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.95 / $46.05 / $130.29	Professional	26	$0.95	$46.05	$130.29
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.35 / $18.16 / $74.59	Professional	TC	$0.35	$18.16	$74.59
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $141.77 / $186.37	Professional		$118.14	$141.77	$186.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $86.68 / $104.02 / $132.63	Professional	26	$86.68	$104.02	$132.63
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $31.46 / $38.15 / $50.30	Professional	TC	$31.46	$38.15	$50.30
United Facility/Professional Professional Modifier Low / Median / High Price $79.41 / $105.66 / $220.56	Professional		$79.41	$105.66	$220.56
United Facility/Professional Professional Modifier 26 Low / Median / High Price $54.31 / $67.88 / $136.43	Professional	26	$54.31	$67.88	$136.43
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $29.32 / $63.65	Professional	TC	$19.57	$29.32	$63.65
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $106.91 / $145.08 / $171.14	Professional		$106.91	$145.08	$171.14
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $81.53 / $105.19 / $126.78	Professional	26	$81.53	$105.19	$126.78
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $25.38 / $39.89 / $45.10	Professional	TC	$25.38	$39.89	$45.10