Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $105.20 / $337.96	Professional		$73.63	$105.20	$337.96
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $31.70 / $69.55 / $433.83	Professional	26	$31.70	$69.55	$433.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $39.83 / $63.39 / $177.74	Professional	TC	$39.83	$63.39	$177.74
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $115.68 / $126.08 / $157.60	Professional		$115.68	$126.08	$157.60
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $45.99 / $45.99 / $67.34	Professional	26	$45.99	$45.99	$67.34
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $58.38 / $80.09 / $98.92	Professional	TC	$58.38	$80.09	$98.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.25 / $68.77 / $205.68	Professional		$48.25	$68.77	$205.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.95 / $82.45	Professional	26	$17.38	$25.95	$82.45
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $24.72 / $43.28 / $123.22	Professional	TC	$24.72	$43.28	$123.22
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $123.04 / $147.31 / $194.18	Professional		$123.04	$147.31	$194.18
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.32 / $48.38 / $62.09	Professional	26	$40.32	$48.38	$62.09
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $82.72 / $99.26 / $132.49	Professional	TC	$82.72	$99.26	$132.49
United Facility/Professional Professional Modifier Low / Median / High Price $80.87 / $101.09 / $191.10	Professional		$80.87	$101.09	$191.10
United Facility/Professional Professional Modifier 26 Low / Median / High Price $29.10 / $36.40 / $72.89	Professional	26	$29.10	$36.40	$72.89
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.36 / $66.70 / $125.05	Professional	TC	$47.36	$66.70	$125.05
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $111.36 / $154.01 / $175.79	Professional		$111.36	$154.01	$175.79
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $36.95 / $48.93 / $58.97	Professional	26	$36.95	$48.93	$58.97
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.41 / $105.08 / $118.78	Professional	TC	$74.41	$105.08	$118.78