Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.92 / $122.42 / $273.52	Professional		$60.92	$122.42	$273.52
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $26.60 / $29.12 / $105.61	Professional	26	$26.60	$29.12	$105.61
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $34.32 / $95.19 / $163.18	Professional	TC	$34.32	$95.19	$163.18
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $52.12 / $150.86 / $186.33	Professional		$52.12	$150.86	$186.33
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $38.34 / $39.84 / $91.45	Professional	26	$38.34	$39.84	$91.45
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $18.18 / $111.02 / $137.12	Professional	TC	$18.18	$111.02	$137.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $73.66 / $176.75	Professional		$40.89	$73.66	$176.75
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.06 / $20.49 / $65.84	Professional	26	$15.06	$20.49	$65.84
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $22.88 / $52.79 / $120.50	Professional	TC	$22.88	$52.79	$120.50
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $149.82 / $179.78 / $237.37	Professional		$149.82	$179.78	$237.37
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $34.95 / $41.94 / $57.44	Professional	26	$34.95	$41.94	$57.44
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $114.87 / $137.84 / $185.31	Professional	TC	$114.87	$137.84	$185.31
United Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $102.78 / $229.15	Professional		$68.56	$102.78	$229.15
United Facility/Professional Professional Modifier 26 Low / Median / High Price $24.75 / $30.02 / $67.55	Professional	26	$24.75	$30.02	$67.55
United Facility/Professional Professional Modifier TC Low / Median / High Price $41.36 / $72.20 / $214.72	Professional	TC	$41.36	$72.20	$214.72
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $96.22 / $188.26 / $213.24	Professional		$96.22	$188.26	$213.24
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $31.53 / $42.39 / $51.11	Professional	26	$31.53	$42.39	$51.11
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $64.69 / $145.87 / $164.89	Professional	TC	$64.69	$145.87	$164.89