Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.71 / $187.45 / $699.32	Professional		$175.71	$187.45	$699.32
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $87.28 / $99.53 / $387.52	Professional	26	$87.28	$99.53	$387.52
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $83.20 / $91.54 / $245.32	Professional	TC	$83.20	$91.54	$245.32
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $152.46 / $253.39 / $321.81	Professional		$152.46	$253.39	$321.81
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $114.35 / $142.01 / $180.35	Professional	26	$114.35	$142.01	$180.35
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $38.11 / $111.38 / $141.44	Professional	TC	$38.11	$111.38	$141.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.94 / $130.63 / $447.05	Professional		$101.94	$130.63	$447.05
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $51.26 / $68.15 / $213.01	Professional	26	$51.26	$68.15	$213.01
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $45.80 / $63.21 / $246.56	Professional	TC	$45.80	$63.21	$246.56
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $242.07 / $290.48 / $405.89	Professional		$242.07	$290.48	$405.89
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $117.91 / $141.49 / $204.73	Professional	26	$117.91	$141.49	$204.73
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $124.16 / $150.52 / $198.42	Professional	TC	$124.16	$150.52	$198.42
United Facility/Professional Professional Modifier Low / Median / High Price $165.78 / $199.63 / $421.85	Professional		$165.78	$199.63	$421.85
United Facility/Professional Professional Modifier 26 Low / Median / High Price $85.06 / $103.68 / $200.84	Professional	26	$85.06	$103.68	$200.84
United Facility/Professional Professional Modifier TC Low / Median / High Price $78.06 / $106.47 / $216.81	Professional	TC	$78.06	$106.47	$216.81
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $222.37 / $299.82 / $348.34	Professional		$222.37	$299.82	$348.34
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $124.55 / $142.44 / $173.45	Professional	26	$124.55	$142.44	$173.45
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $97.82 / $157.37 / $177.89	Professional	TC	$97.82	$157.37	$177.89