Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $239.88	Professional		$72.44	$91.20	$239.88
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $47.86 / $125.89 / $407.38	Professional	26	$47.86	$125.89	$407.38
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.88 / $36.31 / $79.43	Professional	TC	$21.88	$36.31	$79.43
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $81.28 / $102.33	Professional		$29.51	$81.28	$102.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $51.29 / $57.54 / $81.28	Professional	26	$51.29	$57.54	$81.28
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $27.54 / $31.62 / $37.15	Professional	TC	$27.54	$31.62	$37.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.00 / $51.29 / $151.36	Professional		$1.00	$51.29	$151.36
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.69 / $33.88 / $97.72	Professional	26	$0.69	$33.88	$97.72
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.36 / $18.20 / $54.95	Professional	TC	$0.36	$18.20	$54.95
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.65 / $144.54	Professional		$93.33	$109.65	$144.54
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $58.88 / $70.79 / $93.33	Professional	26	$58.88	$70.79	$93.33
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $33.11 / $39.81 / $63.10	Professional	TC	$33.11	$39.81	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $75.86 / $162.18	Professional		$61.66	$75.86	$162.18
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.90 / $52.48 / $104.71	Professional	26	$38.90	$52.48	$104.71
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.05 / $26.30 / $47.86	Professional	TC	$19.05	$26.30	$47.86
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $128.82 / $144.54	Professional		$77.62	$128.82	$144.54
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $54.95 / $81.28 / $91.20	Professional	26	$54.95	$81.28	$91.20
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.39 / $46.77 / $53.70	Professional	TC	$22.39	$46.77	$53.70