Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $141.25 / $575.44	Professional		$89.13	$141.25	$575.44
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $41.69 / $213.80 / $691.83	Professional	26	$41.69	$213.80	$691.83
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $57.54 / $72.44 / $194.98	Professional	TC	$57.54	$72.44	$194.98
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $102.33 / $131.83	Professional		$38.02	$102.33	$131.83
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $33.88 / $45.71 / $61.66	Professional	26	$33.88	$45.71	$61.66
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $52.48 / $74.13 / $93.33	Professional	TC	$52.48	$74.13	$93.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1.38 / $69.18 / $204.17	Professional		$1.38	$69.18	$204.17
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $0.46 / $26.30 / $72.44	Professional	26	$0.46	$26.30	$72.44
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $0.91 / $43.65 / $134.90	Professional	TC	$0.91	$43.65	$134.90
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $151.36 / $199.53	Professional		$128.82	$151.36	$199.53
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $40.74 / $48.98 / $61.66	Professional	26	$40.74	$48.98	$61.66
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $87.10 / $104.71 / $138.04	Professional	TC	$87.10	$104.71	$138.04
United Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $102.33 / $223.87	Professional		$83.18	$102.33	$223.87
United Facility/Professional Professional Modifier 26 Low / Median / High Price $28.84 / $38.02 / $72.44	Professional	26	$28.84	$38.02	$72.44
United Facility/Professional Professional Modifier TC Low / Median / High Price $47.86 / $67.61 / $151.36	Professional	TC	$47.86	$67.61	$151.36
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $177.83 / $199.53	Professional		$112.20	$177.83	$199.53
Wellpoint Facility/Professional Professional Modifier 26 Low / Median / High Price $37.15 / $54.95 / $61.66	Professional	26	$37.15	$54.95	$61.66
Wellpoint Facility/Professional Professional Modifier TC Low / Median / High Price $74.13 / $123.03 / $138.04	Professional	TC	$74.13	$123.03	$138.04