Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $80.34 / $248.67	Professional		$57.19	$80.34	$248.67
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $38.07 / $50.73 / $154.21	Professional	26	$38.07	$50.73	$154.21
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $19.12 / $29.62 / $85.95	Professional	TC	$19.12	$29.62	$85.95
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $99.11 / $99.11 / $122.42	Professional		$99.11	$99.11	$122.42
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $68.62 / $68.62 / $85.78	Professional	26	$68.62	$68.62	$85.78
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $30.14 / $30.49 / $37.65	Professional	TC	$30.14	$30.49	$37.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.57 / $51.89 / $163.91	Professional		$37.57	$51.89	$163.91
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $25.68 / $33.94 / $98.39	Professional	26	$25.68	$33.94	$98.39
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $11.89 / $18.20 / $60.98	Professional	TC	$11.89	$18.20	$60.98
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $93.17 / $110.00 / $145.00	Professional		$93.17	$110.00	$145.00
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $60.31 / $72.37 / $92.64	Professional	26	$60.31	$72.37	$92.64
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $32.85 / $39.42 / $59.85	Professional	TC	$32.85	$39.42	$59.85
United Facility/Professional Professional Modifier Low / Median / High Price $61.01 / $70.03 / $159.28	Professional		$61.01	$70.03	$159.28
United Facility/Professional Professional Modifier 26 Low / Median / High Price $38.89 / $52.26 / $97.98	Professional	26	$38.89	$52.26	$97.98
United Facility/Professional Professional Modifier TC Low / Median / High Price $19.57 / $24.67 / $45.95	Professional	TC	$19.57	$24.67	$45.95
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $77.13 / $115.00 / $134.28	Professional		$77.13	$115.00	$134.28
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $54.79 / $73.31 / $87.96	Professional	26	$54.79	$73.31	$87.96
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $22.33 / $41.68 / $47.11	Professional	TC	$22.33	$41.68	$47.11